Until a couple years ago we used to use Mastisol to secure every ETT. Since then it has been removed from our unit (well it is still there if you know where but very rarely used) due to chemical burns and skin abrasions with extubation especially in the ELBW and VLBW population. Currently we just clean (Sterile Water)/dry the area where we tape the ETT and have not noticed an increase in accidental extubations. It appears to me though that we have to re-tape our ETTs a little more frequent since the removal of Mastisol but we rarely see skin issues anymore.