Patent Publication Number: US-2022233360-A1

Title: Moisture And Electromagnetic Radiation Switchable Adhesive And Apparatuses, Systems, And Methods Therefore

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims priority to and the benefit of U.S. Provisional Application No. 62/858,126, filed Jun. 6, 2019, the contents of which is incorporated into the present application by reference. 
    
    
     TECHNICAL FIELD 
     Aspects of the present disclosure relate generally to a switchable adhesive, such as a light or moisture switchable adhesive for use with medical devices, and more specifically, but not by way of limitation, to an apparatus including the switchable adhesive and an apparatus, system, and method for forming the switchable adhesive. 
     BACKGROUND 
     Switchable (or switched) adhesives are pressure sensitive adhesives that are “switchable” from a tacky state to a non-tacky or low-tack state in which the switched adhesive has a reduced peel strength relative to the peel strength of the adhesive before switching. Conventional switchable adhesives have two states or phases (e.g., off and on). In the first state, the switchable adhesive is tacky and sticks to itself and other objects. Once the conventional switchable adhesive is switched or activated, the conventional switchable adhesive cross-links and becomes brittle and hard, which reduces the tackiness and peel strength. The cross-linking is an irreversible chemical process and thus, a conventional switchable adhesive can only be switched once, from a high tact/peel strength state to a lower tact/peel strength state. Light and moisture switchable adhesives have been incorporated into many products, including some medical devices. 
     When applying medical devices, such as a dressing, the dressing is often repositioned during an initial application of the dressing or the dressing comes into inadvertent contact with an unintended object during application. With conventional adhesives and switchable adhesives, the dressing and adhesive are applied to the patient in a high tact/peel strength state. Thus, a patient may have to go back to the emergency room and undergo anesthesia to have the dressing repositioned/removed or a switchable adhesive of the dressing is activated to facilitate easier removal and the dressing is wasted. Similarly, when a conventional acrylic adhesive or conventional switchable adhesive comes into contact with itself or another component (i.e., not the intended bond site) during application, the components often become inseparable and cannot be separated without damaging the components and/or the adhesive, and thus the components are wasted. As an illustrative example, drape layers can be susceptible to such problems. For example, the drape layer is often thin and has a tendency to bunch up, causing the conventional switchable adhesive to stick to itself and the drape. 
     While silicone adhesives may be reworked and repositioned during application, including worked into creases of the tissue or to accommodate complex shapes, and may be recoverable from unintended contact, silicone adhesives do not offer sufficient bond/peel strength and wearability time as compared to conventional acrylic adhesives or conventional switchable adhesives. Additionally, in some medical applications components (e.g., single use components) may be assembled incorrectly. In such cases, the components cannot be disassembled and reconnected because the conventional acrylic adhesive or the conventional switchable adhesive is not reusable. 
     Therefore, conventional switchable adhesive applications are not repositionable and are harder and less forgiving to apply as compared to silicone adhesives. As a result conventional switchable adhesives and medical devices that incorporate such conventional switchable adhesives can be painful or impossible to reposition and/or reapply. 
     SUMMARY 
     This disclosure describes switchable adhesives, devices including switchable adhesives, and systems and methods related to forming and/or using switchable adhesives. The switchable adhesives described herein include more than two phases, such as three or more phases, also referred to herein as states, and are activated by two different sources, such as moisture and light (electromagnetic radiation). For example, the switchable adhesives (e.g., dual switchable adhesives) described herein include photo initiators and polymerization initiators which transition the switchable adhesive between phases multiple times. To illustrate, the switchable adhesives described herein include (i.e., are transitionable between) a first phase with a low peel strength state and tact, a second phase with a relatively higher peel strength, and a third phase with a relatively lower peel strength. Such switchable adhesives (e.g., dual switchable adhesives) described herein may include or correspond to dual cure switchable adhesives which include two different types of curing agents or systems. Multiple types of curing initiators (e.g., polymerization initiators, photo initiators, etc.) can be used to transition the switchable adhesive between the first, second, and third phases. Accordingly, the switchable adhesives described herein can be repositioned and are resistant to inadvertent contact. 
     To illustrate, the first phase is a partially cured or uncured state and has a low peel strength and tact. In the first phase, the switchable adhesive can be repositioned because it has a low peel strength and tact as compared to conventional light switchable adhesives and acrylic adhesives. As an analogy, the switchable adhesives described herein behave more like silicone adhesives than conventional light switchable adhesives and acrylic adhesives when in the first phase. For, example, the switchable adhesives described herein can be worked into creases or to adapt to complex geometries to accommodate a tissue site and/or patient. However, the switchable adhesives described herein can be cured or increased in a curing amount or degree by applying a first activator (e.g., moisture, light, or both) to increase a peel strength and tact of the switchable adhesive. Thus, the switchable adhesive, once placed in or worked into a desired position, can be set or cured to a second state (an operational state) where the switchable adhesive has a peel strength and tact similar to conventional light switchable adhesives and acrylic adhesives. 
     Similar to conventional light switchable adhesives, the switchable adhesives described herein can be “deactivated” to achieve a lower peel strength responsive to receiving light. To illustrate, the switchable adhesives described herein receive a second activator (e.g., second moisture, light, or both) and transition from the second phase to a third phase where the switchable adhesive can be removed. Accordingly, the switchable adhesives described herein offer stronger peel strengths and longer wear times than silicone adhesives, while offering silicone adhesive like benefits of repositioning with lower tact. The switchable adhesives describe herein are easier to use than acrylic adhesives and conventional light switchable adhesives because they include an extra phase with a lower tact and peel strength to facilitate easier application and repositioning. 
     In some implementations, a switchable adhesive is included in a compound film. An exemplary compound film may include two layers of polymer materials, where the layers are separable or removable. A removable layer can block or filter wavelengths of light that would otherwise activate photo initiators of the switchable adhesive. The removable layer may pass or transmit light that is capable of activating photo initiators of the switchable adhesive. The compound film may be included in medical device to provide for pain and trauma free removal of wound dressing and/or single use connections between components. 
     Thus, the switchable adhesives of the present disclosure are configured to have an additional phase or state, as compared to conventional two phase switchable adhesives or two phase light switchable adhesives. Accordingly, such switchable adhesives can be worked into creases or contoured to a tissue site, can be repositioned, and are more resilient to inadvertent contact or improper assembly than conventional two phase switchable adhesives. Therefore, the switchable adhesives described herein are suitable for use in medical devices, such as bandages, drapes, dressings, and wound closures. The switchable adhesives enable medical devices to be repositioned and removed easily, thereby avoiding or limiting maceration and tissue damage at a tissue site and patient discomfort. Accordingly, the switchable adhesives may enable improved wound care and therapy and increased wear times of medical devices, thereby advancing patient comfort and confidence in the treatment. 
     Additionally, the switchable adhesives of the present disclosure are configured to include different types of curing systems and are activated by two different type of activators. Thus, the switchable adhesives of the present disclose can be activated by ambient moisture from the environment or moisture applied from an applicator. Accordingly, the switchable adhesives of the present disclosure may not utilize multiple different type of light to set and remove. In addition, moisture based curing can penetrate thicker adhesives and components, as compared to light based curing. Accordingly, moisture based curing systems can enable the use of thicker adhesives. 
     Some embodiments of the present compositions (e.g., a dual switchable adhesive or a dual cure switchable adhesive) comprise: one or more polymers; polymerization initiators configured to cause the one or more polymers to cross-link responsive to receiving moisture; and photo initiators configured to cause the one or more polymers to cross-link responsive to receiving light. 
     In some of the foregoing embodiments of the present compositions, the dual switchable adhesive has at least three phases, each phase corresponding to a particular peel strength, and wherein the dual switchable adhesive is configured to transition between a first two phases of the three phases based on activation of the polymerization initiators and to transition between a second two phases of the three phases based on activation of the photo initiators. In other embodiments, the dual switchable adhesive is configured to transition between a first two phases of the three phases based on activation of the photo initiators and to transition between a second two phases of the three phases based on activation of the polymerization initiators. In some implementations, the dual switchable adhesive has a second peel strength in the second phase that is greater than a first peel strength of the dual switchable adhesive in the first phase, and wherein a third peel strength of the dual switchable adhesive in the third phase is less than the second peel strength. 
     In some of the foregoing embodiments of the present compositions, the one or more polymers include an acrylate polymer, and wherein the dual switchable adhesive comprises a polymer composition that includes the one or more polymers, the first photo initiators, and the second photo initiators. In some implementations, the one or more polymers include urethane acrylate, methyl acrylate, silicone acrylate, polyether, polyurethane, or a combination thereof. 
     In some of the foregoing embodiments of the present compositions, the photo initiators have a peak absorbance between 750 nanometers (nm) to 860 nm. In some implementations, the photo initiators have a peak absorbance between 200 nanometers (nm) to 400 nm. In some of the foregoing embodiments of the present compositions, the photo initiators comprise H-Nu-IR 780, H-Nu-IR 815, or both. In some implementations, the photo initiators comprise Irgacure 819. 
     In some of the foregoing embodiments of the present compositions, the dual switchable adhesive has a peel strength of less than 7 N/25 mm on stainless steel at 180 degrees in a first phase. In some implementations, the dual switchable adhesive has a peel strength of greater 8 N/25 mm on stainless steel at 180 degrees in a second phase. Additionally, or alternatively, the dual switchable adhesive has a peel strength of less than 7 N/25 mm on stainless steel at 180 degrees in a third phase. 
     In some of the foregoing embodiments of the present compositions, the dual switchable adhesive has an areal weight of 100 to 250 grams per square meter (gsm). In some implementations, the dual switchable adhesive has a moisture vapor transfer rate (MVTR) of greater than 250 g/m 2 . Additionally, or alternatively, the dual switchable adhesive has a dynamic viscosity of 320-500 millipascal-second (mPa*s) when in a first phase. 
     In some of the foregoing embodiments of the present compositions, the dual switchable adhesive has a second level of cross-linking in the second phase that is greater than a first level of cross-linking in the first phase, and wherein the dual switchable adhesive has a third level of cross-linking in the third phase that is greater than the second level of cross-linking. 
     Some embodiments of the present apparatuses (e.g., a compound film) comprise: a first layer of a first polymer composition; a second layer of a second polymer composition, the second layer removeably coupled to the first layer; and a dual switchable adhesive of the foregoing embodiments coupled to the second polymer layer. In some of the foregoing embodiments of the present apparatuses: the first layer is in direct contact with the second layer; and the dual switchable adhesive is in direct contact with the second layer. In some implementations, the first layer is opaque and the second layer is optically transparent. 
     In some of the foregoing embodiments of the present apparatuses: the first layer is configured to block or filter ultraviolet (UV) light, visible light, or both; and the second layer is configured to pass UV light, visible light, or both. In some implementations, the second layer is configured to diffuse UV light, visible light, or both. In some of the foregoing embodiments of the present apparatuses: the second layer is configured to pass visible light, infrared light, or both; and the first layer is configured to block or filter visible light. 
     In some of the foregoing embodiments of the present apparatuses, the apparatuses further comprise a cover film removeably coupled to the dual switchable adhesive. In some implementations, the first layer is included in a drape, a bandage, a wound closure device, a therapy system adhesive, or a combination thereof. 
     In some of the foregoing embodiments of the present apparatuses, the dual switchable adhesive, the first layer, the second layer, or a combination thereof, define a plurality of perforations. In some implementations, the dual switchable adhesive is arranged in a pattern. 
     Some embodiments of the present systems comprise: a medical device including the dual switchable adhesive of any of the foregoing embodiments. In some of the foregoing embodiments of the present systems, the systems further comprise a therapy device coupled to the medical device and configured to provide therapy via the medical device. In some implementations, the systems further comprise a light source configured to emit light to the dual switchable adhesive to transition the dual switchable adhesive from a first phase to a second phase. 
     In some of the foregoing embodiments of the present systems, the medical device comprises a wound dressing, a bandage, or a wound closure device. In some implementations, the dual switchable adhesive is coupled to a compound film, and the compound film corresponds to a protective film and a drape layer of the wound dressing. In other implementations, the medical device comprises a connector of the system, and the dual switchable adhesive is coupled an interface of the connector and is configured to form a connection point between two components of the system. 
     Some embodiments of the present methods of manufacturing dual switchable adhesive comprise: providing polymerization initiators to one or more polymers, the polymerization initiators configured to increase a cross-linking of the one or more polymers responsive to receiving moisture; providing photo initiators to the one or more polymers, the photo initiators configured to increase the cross-linking of the one or more polymers responsive to receiving light; and blending the one or more polymers, the polymerization initiators, and the photo initiators to form a polymer composition. 
     In some of the foregoing embodiments of the present methods, the methods further comprise providing one or more co-initiators configured to assist the first photo initiators, the first photo initiators, or both, in curing the one or more polymers. In some implementations, the one or more the co-initiators include Borate V, Irgacure 184, or both. 
     In some of the foregoing embodiments of the present methods, the methods further comprise providing one or more solvents configured to increase a solubility of the first photo initiators, the first photo initiators, or both, in the one or more polymers. In some implementations, the one or more solvents include N,N-Dimethylacrylamide (DMAA), ketones, or both. In some of the foregoing embodiments of the present methods, the methods further comprise partially curing the polymer composition by applying heat, light, or both. 
     In some of the foregoing embodiments of the present methods, the polymer composition comprises a dual switchable adhesive, and the methods further comprise applying the dual switchable adhesive to a film. In some implementations, applying the dual switchable adhesive to the film includes applying a coating of the dual switchable adhesive by a roller, a slot die, or a spray nozzle. In a particular implementation, applying the dual switchable adhesive to the film includes applying the dual switchable adhesive in a pattern. Additionally, or alternatively, the methods may further comprise coupling a cover film to the dual switchable adhesive. In some of the foregoing embodiments of the present methods, the methods further comprise forming perforations in the dual switchable adhesive, the cover film, or a combination thereof. 
     Some embodiments of the present methods of using dual switchable adhesive comprise: attaching a component to a tissue site via a dual switchable adhesive to form a bond between the component and the tissue site; applying moisture to the dual switchable adhesive to increase a bond strength of the bond between the component and the tissue site; applying light to the dual switchable adhesive to decrease the bond strength of the bond between the component and the tissue site; and removing the component from the tissue site. In some of the foregoing embodiments of the present methods, the methods further comprise applying second light to the dual switchable adhesive to increase or decrease the bond strength of the bond between the component and the tissue site, the second light different from the light. 
     In some of the foregoing embodiments of the present methods, the methods further comprise, prior to attaching the component, removing a cover film from the dual switchable adhesive. In some implementations, the methods further comprise, after applying the moisture, removing a protective film from the component, wherein removing the protective film enables application of the second light to the dual switchable adhesive. 
     Some embodiments of the present methods of using dual switchable adhesive comprise: receiving, at a dual switchable adhesive of a component, moisture; responsive to receiving the moisture, transitioning, by the dual switchable adhesive, from a first phase to a second phase; receiving, at the dual switchable adhesive, light; and responsive to receiving the light, transitioning, by the dual switchable adhesive, from the second phase to a third phase. In some of the foregoing embodiments of the present methods, the methods further comprise receiving, at the dual switchable adhesive, second light, the second light different from the light; and responsive to receiving the second light, transitioning, by the dual switchable adhesive, from the third phase to a fourth phase or from a fourth phase to the first phase. 
     In some of the foregoing embodiments of the present methods, the methods further comprise, after receiving the second light, decreasing, by the dual switchable adhesive, a bond strength between the component and a tissue site. In some implementations, the methods further comprise, after receiving the second light, debonding, by the dual switchable adhesive, the component from a tissue site, wherein the third phase has a lower peel strength than the second phase. 
     In some of the foregoing embodiments of the present methods, the methods further comprise, responsive receiving the moisture or the light, changing color by the dual switchable adhesive. In some implementations, the methods further comprise, prior to receiving the moisture, bonding, by the dual switchable adhesive, the component to a tissue site. Additionally, or alternatively, the methods further comprise, after receiving the moisture, increasing, by the dual switchable adhesive, a bond strength between the component and the tissue site. 
     Some embodiments of the present methods of using dual switchable adhesive comprise: applying moisture by a moisture source, the moisture configured to cause a dual switchable adhesive to transition from a first phase to a second phase; and emitting light by a light device, the light and configured to cause the dual switchable adhesive to transition from the second phase to a third phase. In some of the foregoing embodiments of the present methods, the methods further comprise emitting second light by the light device, the second light different from the light and configured to cause the dual switchable adhesive to transition from the first phase to the second phase or from the second phase to the third phase. 
     In some of the foregoing embodiments of the present methods, the methods further comprise: emitting reference light; determining a distance to a surface based on the reference light; and outputting an indication of the determined distance, wherein the light comprises one of UV light, visible light, or infrared light. In a particular implementation, the light comprises UV light. 
     In some of the foregoing embodiments of the present methods, the light has a wavelength between 650 nanometers (nm) and 850 nm. Alternatively, the light has as a wavelength between 200 nanometers (nm) and 450 nm. 
     Some embodiments of the present kits (e.g., a kit for a dual switchable adhesive) comprise: a three phase dual switchable adhesive configured to transition between a first phase and a second phase responsive to receiving one of moisture or light and to transition between the second phase and a third phase responsive to receiving the other of the moisture or light. 
     In some of the foregoing embodiments of the present kits, the light corresponds to ultraviolet light, and further comprising a light device configured to emit ultraviolet light. Additionally, or alternatively, the moisture includes water or water vapor, and further comprising an applicator including the moisture and configured to apply the moisture. 
     In some of the foregoing embodiments of the present kits, the applicator comprises a wipe or a spray bottle. In some implementations, the kits further comprise a package that includes the three phase dual switchable adhesive. 
     Some embodiments of the present kits (e.g., a kit for a dual switchable adhesive) comprise: a pouch; and a sterilized drape including a three phase dual switchable adhesive and positioned within the pouch. In some of the foregoing embodiments of the present kits, the pouch further comprises one or more valves, a window, or both. In some implementations, the one or more valves are configured to enable the pouch to equalize to atmospheric pressure. 
     In some of the foregoing embodiments of the present kits, the pouch comprises a material that is permeable to ethylene oxide gas and that is a non-permeable to water. 
     In some implementations, the pouch comprises a second material that is that is a non-permeable to water or the material that is permeable to the ethylene oxide gas is further non-permeable to water. Additionally, or alternatively, the kits further comprise a package that includes the pouch. 
     As used herein, the term “switchable” will be used to refer to adhesives which can be changed at least from one state or phase (e.g., a high tack and/or peel strength state) to another state or phase (e.g., a low tack and/or peel strength state, such as a non-tacky state). Recognizing that the expression “low tack and/or peel strength” is a relative term, it will be defined here as meaning a condition of a minimum reduction in tackiness which the adhesive reaches after switching from the high tack and/or peel strength state. The reduction in tack or peel force may be as great as 99% or as little as 30%. Typically, the reduction in tack or peel force is between 70% and 90%. 
     As used herein, the term “peel strength” will be used to refer to a strength of adhesives measured by a 180 degree peel test on stainless steel. Recognizing that a bond strength of adhesive depends on the medium to which it adheres and that tissue composition can vary greatly, the measured peel strength is indicative of the adhesive&#39;s bond strength with tissue. 
     As used herein, various terminology is for the purpose of describing particular implementations only and is not intended to be limiting of implementations. For example, as used herein, an ordinal term (e.g., “first,” “second,” “third,” etc.) used to modify an element, such as a structure, a component, an operation, etc., does not by itself indicate any priority or order of the element with respect to another element, but rather merely distinguishes the element from another element having a same name (but for use of the ordinal term). The term “coupled” is defined as connected, although not necessarily directly, and not necessarily mechanically. Additionally, two items that are “coupled” may be unitary with each other. To illustrate, components may be coupled by virtue of physical proximity, being integral to a single structure, or being formed from the same piece of material. Coupling may also include mechanical, thermal, electrical, communicational (e.g., wired or wireless), or chemical coupling (such as a chemical bond) in some contexts. 
     The terms “a” and “an” are defined as one or more unless this disclosure explicitly requires otherwise. The term “substantially” is defined as largely but not necessarily wholly what is specified (and includes what is specified; e.g., substantially 90 degrees includes 90 degrees and substantially parallel includes parallel), as understood by a person of ordinary skill in the art. As used herein, the term “approximately” may be substituted with “within 10 percent of” what is specified. Additionally, the term “substantially” may be substituted with “within [a percentage] of” what is specified, where the percentage includes 0.1, 1, or 5 percent; or may be understood to mean with a design, manufacture, or measurement tolerance. The phrase “and/or” means and or. To illustrate, A, B, and/or C includes: A alone, B alone, C alone, a combination of A and B, a combination of A and C, a combination of B and C, or a combination of A, B, and C. In other words, “and/or” operates as an inclusive or. 
     The terms “comprise” (and any form of comprise, such as “comprises” and “comprising”), “have” (and any form of have, such as “has” and “having”), and “include” (and any form of include, such as “includes” and “including”). As a result, an apparatus that “comprises,” “has,” or “includes” one or more elements possesses those one or more elements, but is not limited to possessing only those one or more elements. Likewise, a method that “comprises,” “has,” or “includes” one or more steps possesses those one or more steps, but is not limited to possessing only those one or more steps. 
     Any aspect of any of the systems, methods, and article of manufacture can consist of or consist essentially of—rather than comprise/have/include—any of the described steps, elements, and/or features. Thus, in any of the claims, the term “consisting of” or “consisting essentially of” can be substituted for any of the open-ended linking verbs recited above, in order to change the scope of a given claim from what it would otherwise be using the open-ended linking verb. Additionally, it will be understood that the term “wherein” may be used interchangeably with “where.” 
     Further, a device or system that is configured in a certain way is configured in at least that way, but it can also be configured in other ways than those specifically described. The feature or features of one embodiment may be applied to other embodiments, even though not described or illustrated, unless expressly prohibited by this disclosure or the nature of the embodiments. 
     Some details associated with the aspects of the present disclosure are described above, and others are described below. Other implementations, advantages, and features of the present disclosure will become apparent after review of the entire application, including the following sections: Brief Description of the Drawings, Detailed Description, and the Claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       A further understanding of the nature and advantages of the present disclosure may be realized by reference to the following drawings. The following drawings illustrate by way of example and not limitation. For the sake of brevity and clarity, every feature of a given structure is not always labeled in every figure in which that structure appears. Identical reference numbers do not necessarily indicate an identical structure. Rather, the same reference number may be used to indicate a similar feature or a feature with similar functionality, as may non-identical reference numbers. 
         FIG. 1A  is a block diagram of an example of a system for activating a dual switchable adhesive; 
         FIG. 1B  is a side view of an example of a compound film including a dual switchable adhesive; 
         FIG. 2A  is diagram illustrating representative chemical reactions of a dual switchable adhesive; 
         FIGS. 2B-2D  are each a representative chemical view of phases of an example of a dual switchable adhesive; 
         FIGS. 3A-3D  are each a diagram illustrating representative chemical reactions of a dual switchable adhesive; 
         FIG. 4A  is diagram illustrating peel strength of a dual switchable adhesive and a degree of cross-linking of the dual switchable adhesive; 
         FIG. 4B  is diagram illustrating chain-growth polymerization and step-growth polymerization with respect to concentration and molecular weight; 
         FIGS. 5A-5D  are each a side view of an example of attaching and removing a compound film including dual switchable adhesive from tissue; 
         FIGS. 6A-6C  are each a diagram illustrating a chemical formula of an example of a photo initiator of a dual switchable adhesive; 
         FIG. 7A  is a diagram of an example of a therapy system including a dual switchable adhesive; 
         FIG. 7B  is a diagram of an example of a drape of the therapy system of  FIG. 7A  including a dual switchable adhesive; 
         FIG. 8  is a block diagram of a manufacturing system for manufacturing a dual switchable adhesive and coating objects with the dual switchable adhesive; 
         FIG. 9  is a block diagram of an example of a kit for dual switchable adhesives; 
         FIG. 10  is a block diagram of an example of a pouch for dual switchable adhesives; 
         FIG. 11  is a flowchart illustrating an example of a method of manufacturing dual switchable adhesive; 
         FIG. 12  is a flowchart illustrating an example of a method of using dual switchable adhesive; 
         FIG. 13  is a flowchart illustrating an example of another method of using dual switchable adhesive; 
         FIG. 14  is a flowchart illustrating an example of a method activating a dual switchable adhesive; and 
         FIG. 15  is a flowchart illustrating an example of a method activating a dual switchable adhesive. 
     
    
    
     DETAILED DESCRIPTION 
     As used herein, the terms “tissue site” and “target tissue” as used herein can broadly refer to a wound (e.g., open or closed), a tissue disorder, and/or the like located on or within tissue, such as, for example, bone tissue, adipose tissue, muscle tissue, neural tissue, dermal tissue, vascular tissue, connective tissue, cartilage, tendons, ligaments, and/or the like. The terms “tissue site” and “target tissue” as used herein can also refer to a surrounding tissue area(s) and/or areas of tissue that are not necessarily wounded or exhibit a disorder, but include tissue that would benefit from tissue generation and/or tissue that may be harvested and transplanted to another tissue location. The terms “tissue site” and “target tissue” may also include incisions, such as a surgical incision. In some implementations, “target tissue” may correspond or refer to a wound, and “tissue site” may correspond or refer to a tissue area(s) surrounding and including the target tissue. Additionally, the term “wound” as used herein can refer to a chronic, subacute, acute, traumatic, and/or dehisced incision, laceration, puncture, avulsion, and/or the like, a partial-thickness and/or full thickness burn, an ulcer (e.g., diabetic, pressure, venous, and/or the like), flap, and/or graft. A wound may include chronic, acute, traumatic, subacute, and dehisced wounds, partial-thickness burns, ulcers (such as diabetic, pressure, or venous insufficiency ulcers), flaps, grafts, and fistulas, for example. 
     The term “positive-pressure” (or “hyperbaric”) as used herein generally refers to a pressure greater than a local ambient pressure, such as the ambient pressure in a local environment external to a sealed therapeutic environment (e.g., an internal volume). In most cases, this positive-pressure will be greater than the atmospheric pressure at which the patient is located. Alternatively, the positive-pressure may be greater than a hydrostatic pressure associated with tissue at the tissue site. Unless otherwise indicated, values of pressure stated herein are gauge pressures. References to increases in positive-pressure typically refer to an increase in absolute pressure, and decreases in positive-pressure typically refer to a decrease in absolute pressure. Additionally, the process of increasing pressure may be described illustratively herein as “applying”, “delivering,” “distributing,” “generating”, or “providing” positive-pressure, for example. 
     The term “reduced-pressure” (and “negative-pressure” or “hypobaric”) as used herein generally refers to a pressure less than a local ambient pressure, such as the ambient pressure in a local environment external to a sealed therapeutic environment (e.g., an internal volume). In most cases, this reduced-pressure will be less than the atmospheric pressure at which the patient is located. Alternatively, the reduced-pressure may be less than a hydrostatic pressure associated with tissue at the tissue site. Unless otherwise indicated, values of pressure stated herein are gauge pressures. References to increases in reduced-pressure typically refer to a decrease in absolute pressure, and decreases in reduced-pressure typically refer to an increase in absolute pressure. Additionally, the process of reducing pressure may be described illustratively herein as “applying”, “delivering,” “distributing,” “generating”, or “providing” reduced-pressure, for example. 
     The term “fluid” may refer to liquid, gas, air, or a combination thereof. The term “fluid seal,” or “seal,” means a seal adequate to maintain a pressure differential (e.g., positive-pressure or reduced-pressure) at a desired site given the particular pressure source or subsystem involved. Similarly, it may be convenient to describe certain features in terms of fluid “inlet” or “outlet” in such a frame of reference. However, the fluid path may also be reversed in some applications, such as by substituting a reduced-pressure source (negative or hypobaric pressure source) for a positive-pressure source, and this descriptive convention should not be construed as a limiting convention. 
       FIG. 1A  illustrates a block diagram of an illustrative system  100  for activating a dual switchable adhesive. System  100  includes a dual switchable adhesive (DSA)  110  (e.g., a three or more phase dual switchable adhesive), a light device  112 , and a moisture source  114 . DSA  110  includes two or more different types of curing systems, such as a moisture curing system and a light curing system. DSA  110  may include or correspond to a moisture switchable adhesive (MSA) and a light switchable adhesive (LSA). 
     System  100  is configured to activate the DSA  110  to transition or switch the DSA  110  between multiple phases, such as from a first phase  142  to a second phase  144 , and from the second phase  144  to a third phase  146 . For example, system  100  may apply light of a particular wavelength(s) to DSA  110  to activate photo initiators  122  thereof to control a peel strength of the DSA  110  and apply a particular type of moisture (e.g., chemical compound in a liquid or gas state) to DSA  110  to activate polymerization initiators  124  thereof to control a peel strength of the DSA  110 . One such exemplary use of DSA  110  is as a repositionable light and moisture switchable adhesive for medical applications and devices. 
     The DSA  110  includes or correspond to a pressure sensitive adhesive. As illustrated in  FIG. 1A , the DSA  110  includes one or more polymers  120 , photo initiators  122 , and polymerization initiators  124 . The one or more polymers  120 , the photo initiators  122 , and the polymerization initiators  124  may include or correspond to a polymer composition. Although a single type of photo initiator and a single type of polymerization initiator are illustrated in  FIG. 1A , additional types of photo initiators and/or polymerization initiators may be included in other implementations. DSA  110  may include a light curing system of a light switchable adhesive as described in International Patent Application Nos. PCT/US2018/049388 and PCT/US2018/060718, which are incorporated by reference herein to the extent they describe light switchable adhesives. 
     The one or more polymers  120  may include chains of one or more monomers (e.g., polymer chains) and free monomers. The one or more polymers  120  may include or correspond to an uncured or partially cured polymer composition and may be cured (or partially cured) responsive to receiving light from the light device  112  and moisture from the moisture source  114 . In some implementations, the one or more polymers  120  are acrylic based, such as includes acrylate, urethane acrylate, alkoxy acrylate, and/or silicone acrylate based polymers and oligomers. The one or more polymers  120  may include or further include polyether, polyurethane, methacrylate, or a combination thereof. 
     The photo initiators  122  (e.g., first type curing initiators) are configured to cause cross-linking of monomers and/or polymer chains of the one or more polymers  120  to increase a degree of cross linking of the one or more polymers  120  or a degree of curing of the one or more polymers  120  responsive to receiving light of a particular wavelength, i.e., first light. For example, the photo initiators  122  are configured to generate free radicals (e.g., first free radicals) responsive to receiving first light  132  from the light device  112 . The free radicals are configured to active the one or more polymers  120  (e.g., monomers or polymer chains thereof) to increase bonding between the one or more polymers  120 , such as increase polymer chain lengths, reduce free monomers, or both, as described further with reference to  FIGS. 2A-2D . 
     As an illustrative, non-limiting example, the photo initiators  122  include ultraviolet (UV) type photo initiators, i.e., photo initiators that are activated by light near or within the ultraviolet spectrum. Additionally, or alternatively, the photo initiators  122  include visible light type photo initiators or infrared (IR) type photo initiators. Exemplary photo initiators are described further with reference to  FIGS. 2A-2D and 5A-5C . 
     The photo initiators  122  may have a concentration (e.g., weight percentage) of 0.5 to 10 percent of the total weight of the DSA  110  (polymer composition). In a particular implementation, the photo initiators  122  have a concentration (e.g., weight percentage) of 2 to 6 percent of the total weight of the DSA  110  (polymer composition). 
     Similarly, the polymerization initiators  124  (e.g., second type curing initiators) are configured to cause cross-linking of monomers and/or polymer chains of the one or more polymers  120  to increase a degree of cross linking of the one or more polymers  120  or a degree of curing of the one or more polymers  120  responsive to receiving light of a particular wavelength. For example, the polymerization initiators  124  are configured to increase curing responsive to receiving moisture  134  from the moisture source  114 . In some implementations, the polymerization initiators  124  cause a condensation reaction responsive to receiving moisture  134  from the moisture source  114 . The polymerization initiators  124  may proceed in a stepwise fashion to produce an addition reaction (generate an adduct) and release a byproduct. The addition reaction increases a chain length of the one or more polymers  120  and may increase cross-linking of the one or more polymers  120 . In other implementations, the polymerization initiators  124  generate free radicals (e.g., second free radicals) responsive to receiving moisture  134  from the moisture source  114 . The free radicals are configured to active the one or more polymers  120  (e.g., monomers or polymer chains thereof) to increase bonding between the one or more polymers  120 , such as increase polymer chain lengths, reduce free monomers, or both. 
     The polymerization initiators  124  may have a concentration (e.g., weight percentage) of 0.5 to 10 percent of the total weight of the DSA  110  (polymer composition). In a particular implementation, the polymerization initiators  124  have a concentration (e.g., weight percentage) of 2 to 6 percent of the total weight of the DSA  110  (polymer composition). 
     In some implementations, the DSA  110  includes one or more additives  126 . The additive  126  may include or correspond to additives to increase dissolution of the photo initiators  122 , the polymerization initiators  124 , or both in a particular polymer or to increase free radical production and/or curing. For example, DMAA (N,N-Dimethylacrylamide) and/or ketones can be used to increase solubility of photo initiators  122  in acrylate resins. As another example, certain co-initiators, such as Borate V or Irgacure 184, may increase a speed of free radical cure. 
     Additionally, or alternatively, the additives  126  include a marking additive, such as an IR marking additive, a UV marking additive, or a visible light marking additive. Such marking additives may produce a visual indication, such as a color change, text, a symbol, etc., to indicate that light of a particular wavelength which may activate DSA  110  has been received or that a transition of states has occurred. 
     In a particular implementation, the UV marking additive includes or corresponds to an ultraviolet absorber (UV absorber). A UV absorber is a molecule used in organic or synthetic materials to absorb UV radiation. The UV absorbers are configured to absorb at least a portion of UV radiation of the UV spectrum and produce a visual indication, such as a color change. For example, UVA absorbers are configured to absorb UVA radiation, i.e., electromagnetic radiation having wavelengths between 300 and 400 nm. Additionally, or alternatively, one or more other layers of a compound film  152  may include a UV marking additive or another additive, such as a visible light additive. For example, a first layer (e.g.,  192 , such as a light blocking layer or protective film) and/or a second layer (e.g.,  194 , such as a non-light blocking layer or adhesive layer) may include a marking additive. Such marking additives may produce a color change, produce text, produce a symbol, etc. to indicate light which may activate DSA  110  has been received. 
     Additionally, or alternatively, the reaction or reactions caused by a particular photo initiator may provide a visual indication. To illustrate, IR photo initiators may produce a color change upon receiving light and producing a free radical, upon the free radical altering a monomer/polymer, upon cross-linking or combining of monomers/polymers, or a combination thereof. 
     In some implementations, such as for UV photo initiators, the photo initiators  122  have a peak absorbance between 200 nanometers (nm) to 400 nm. In a particular implementation, the photo initiators  122  have a peak absorbance of about 385 nm. In other implementations, such as for IR photo initiators, the photo initiators  122  have a peak absorbance between 750 nanometers (nm) to 860 nm. In a particular implementation, the photo initiators  122  have a peak absorbance of about 780 nm or about 815 nm. 
     In some implementations, DSA  110  has a peel strength of less than 7 N/25 mm on stainless steel at an angle of 180 degrees at room temperature in the first phase  142 . In a particular implementation, DSA  110  has a peel strength between 4N/25 mm and 6N/25 mm on stainless steel at an angle of 180 degrees at room temperature in the first phase  142 . In some such implementations, the dual switchable adhesive has a peel strength of greater 8 N/25 mm on stainless steel at an angle of 180 degrees at room temperature in the second phase  144 . In a particular implementation, DSA  110  has a peel strength of greater than 15N/25 mm on stainless steel at an angle of 180 degrees at room temperature in the first phase  142 . In another implementation, DSA  110  has a peel strength between 10N/25 mm and 15N/25 mm on stainless steel at an angle of 180 degrees at room temperature in the first phase  142 . Additionally, or alternatively, the dual switchable adhesive has a peel strength of less than 7 N/25 mm on stainless steel at an angle of 180 degrees at room temperature in a third phase  146 . In a particular implementation, the DSA has a peel strength between 3N/25 mm and 6N/25 mm on stainless steel at an angle of 180 degrees at room temperature in a third phase. 
     In some implementations, DSA  110  has an areal weight of 50 to 300 grams per square meter (gsm). In a particular implementation, DSA  110  has an areal weight of 100 to 250 grams per square meter (gsm). In some implementations, DSA  110  has a moisture vapor transfer rate (MVTR) of greater than 250 g/m 2  in the first phase  142 , the second phase  144 , or both. In a particular implementation, LSA  110  has a MVTR of 250 g/m 2  to 1000 g/m 2  in the first phase  142 , the second phase  144 , or both. In other implementations, the LSA has a MVTR of greater than 1000 g/m 2  in the first phase  142 , the second phase  144 , or both. 
     Additionally, or alternatively, LSA  110  has a viscosity which produces 7 mm to 11 mm of cone penetration according to ISO 2137, alternatively referred to as 70 mm/10 to 110 mm/10, in the first phase  142 , the second phase  144 , or both, in some implementations. In a particular implementation, LSA  110  has a viscosity which produces 9 mm of cone penetration according to ISO 2137, alternatively referred to as 90 mm/10, in the first phase  142 , the second phase  144 , or both. To illustrate, the viscosity is measured by a penetrometer according to the standard Norfolk Island (NF) International Organization for Standardization (ISO) 2137, using a penetrometer PNR 12 Petrotest model with a total weight of the rod and cone attached thereto is 62.5 grams. Cone penetration of a sample (i.e., the DSA  110 ) in a container is determined at 25° C. by measuring the depth of penetration of the cone penetrometer into the sample after releasing the cone penetrometer and allowing the cone penetrometer to act for 5 seconds. The measured penetration depth is often multiplied by 10 and notated in “N” mm/10. 
     The light device  112  is configured to provide light to activate DSA  110  (i.e., photo initiators  122 , second photo initiators, or both, thereof) and cause DSA  110  to switch phases (e.g.,  142  to  144  or  144  to  146 ), also referred to as states. Light device  112  may include or correspond to the Sun, ambient lighting, a dedicated light device, such as an infrared (IR) device, a visible light device, an ultraviolet (UV) device, a dual light device, or a combination thereof. 
     An exemplary UV device is configured to generate/emit UV light to activate DSA  110  (photo initiators thereof) and cause DSA  110  to switch phases (e.g.,  142  to  144  or  144  to  146 ). For example, UV device includes or corresponds to a UV light source configured to generate light or electromagnetic radiation having a wavelength of 10-500 nanometers, such as UV light to blue light. In some implementations, UV device may include or correspond to a UV torch. For example, UV torch may include one or more LEDs configured to generate incoherent light in the UV spectrum. In a particular implementation, UV torch generates light in a particular subspectrum of the UV spectrum, such as UVA or UVC. 
     In other implementations, the UV device may include or correspond to a UV Laser, such as a gas laser, a laser diode, a solid-state laser, an excimer laser, or a combination thereof. In some implementations, UV laser is configured to generate coherent light (e.g., a laser beam) having electromagnetic radiation of UV wavelengths. For example, UV laser is a UVA laser (315-400 nm), a UVB laser (280-315 nm), a UVC laser (100-280 nm), or an extreme UV laser (10-121 nm). 
     An exemplary IR device is configured to generate/emit IR light to activate DSA  110  (photo initiators thereof) and cause DSA  110  to switch phases (e.g.,  142  to  144  or  144  to  146 ). For example, IR device includes or corresponds to a IR light source configured to generate IR light or electromagnetic radiation having a wavelength of 700 nanometers (nm)-1 millimeter (mm). In some implementations, IR device may include or correspond to a IR torch. For example, IR torch may include one or more LEDs configured to generate incoherent light in the IR spectrum. In a particular implementation, IR torch generates light in a particular subspectrum of the IR spectrum, such as near-infrared (NIR or IR-A) or short-wavelength infrared (SWIR or IR-B). 
     In other implementations, the IR device may include or correspond to an IR Laser, such as a gas laser, a laser diode, a solid-state laser, an excimer laser, or a combination thereof. In some implementations, IR laser is configured to generate coherent light (e.g., a laser beam) having electromagnetic radiation of IR wavelengths. For example, IR laser is a IR-A laser (700-1400 nm), a IR-B laser (1400-3000 nm), or an IR-C laser (3000 nm-1 mm). 
     An exemplary visible light device is configured to generate/emit visible light to activate DSA  110  (photo initiators thereof) and cause DSA  110  to switch phases (e.g.,  142  to  144  or  144  to  146 ). For example, visible device includes or corresponds to a visible light source configured to generate light or electromagnetic radiation having a wavelength of about 400-700 nanometers, such as violet light to red light. In some implementations, the visible light device may include or correspond to a visible light torch. For example, visible light torch may include one or more LEDs configured to generate incoherent light in the visible light spectrum. In a particular implementation, the visible light torch generates light in a particular subspectrum of the visible light spectrum, such as green light or orange light. In another implementations, the visible light torch generates light in various subspectrums of the visible light spectrum, such as violet, blue, green, yellow, etc. to generate “white” light. 
     Similarly, the moisture source  114  is configured to provide moisture  134  to activate DSA  110  (polymerization initiators  124  thereof) and cause DSA  110  to switch phases (e.g.,  142  to  144  or  144  to  146 ). Moisture source  114  may include or correspond to environmental or ambient moisture (e.g., humidity, tissue moisture, etc.), a dedicated moisture source such as a wipe, an applicator (e.g., a spray bottle), or a combination thereof. In such implementations where the moisture source  114  is a dedicated moisture source/device (e.g., a wipe or an applicator), the moisture source  114  may be configured to apply moisture  134  to the DSA  110 , such as atomized water droplets, steam, liquid water, etc. In some implementations, the moisture  134  includes or correspond to water, such as sterilized water, de-ionized water, etc. In other implementations, the moisture  134  includes or corresponds to a solution, such as water mixed with a urea, an amine, an alcohol, etc., or a combination thereof. In some such implementations, one part of the solution activates the polymerization initiators  124  and another part of the solution performs another function, such as antiseptic or sterilization. Alternatively, multiple or both parts of the solution activate the polymerization initiators  124 . 
     Optionally, system  100  includes a light source  116  in addition to or in the alternative of light device  112 . Similarly, in some implementations, the light source  116  is configured to provide light to activate DSA  110  and cause DSA  110  to switch phases (e.g.,  142  to  144  or  144  to  146 ). Light source  116  may include or correspond to the Sun, ambient lighting, a second dedicated light device, such as an ultraviolet (UV) device, or a combination thereof. In such implementations where the light source  116  is a second dedicated light device, the light source  116  may include or correspond to one or more components described with reference to the light device  112 . 
     Although two polymerization initiators are illustrated in  FIG. 1A , in other implementations additional polymerization initiators may be used. For example, DSA  110  may include, in some implementations, second photo initiators configured to respond to the second light  136 . The second photo initiators (e.g., third polymerization initiators) can be used to augment or supplement (e.g., speed up) a particular transition, e.g., from the second phase  144  to the third phase  146  to facilitate removal, or the second photo initiators can be used to add an additional phase or state, such as a fourth phase or state. For example, the second photo initiators are configured to be activated responsive to receiving the second light  136 , and the photo initiators  122  and the second photo initiators (which are similar to the photo initiators  122 ) transition DSA  110  from the first phase  142  to the second phase  144  or from the second phase  144  to the third phase  146 . 
     Alternatively, the second photo initiators (e.g., third polymerization initiators) can be used to add an additional phase or state. An additional phase or state can be used in attachment of the DSA  110 , i.e., to get a larger increase in peel/bond strength, or in the removal of the DSA  110 , i.e., to get a larger decrease in peel/bond strength. In some such implementations, the second photo initiators (e.g., third polymerization initiators) include or correspond to visible light photo initiators. As illustrative, non-limiting examples, the visible light photo initiators include or correspond to H-Nu-Blue 660, H-Nu-Blue 660, or a combination thereof. 
     One particular use for DSA  110  is illustrated in  FIG. 1B . Other examples of use and manufacture of a DSA, such as DSA  110 , are described with reference to  FIGS. 5A-5D, 7A, and 8 . Referring to  FIG. 1B , a side view of a particular example of a compound film  152  including a dual switchable adhesive is illustrated. In  FIG. 1B , compound film  152  includes a first layer  192  (e.g., a protective film), a second layer  194  (e.g., a DSA host layer or adhesive layer), DSA  110 , and an optional cover film  198 . 
     Layers  192 ,  194  may include polymer films. In a particular implementation, the layers  192 ,  194  have similar polymer materials or the same polymer material. For example, one or more of layers  192 ,  194  may be polyurethane (PU) films, polyethylene (PE) films, etc. In dual switchable adhesive related applications, one of layers  192 ,  194  is a light blocking film with respect to at least a first type of light (e.g.,  132  or  136 ) and the other of layers  192 ,  194  is a non-light blocking film or light passing (e.g., transmitting) film with respect to the first type of light. In some implementations, the second layer  194  may include or correspond to a drape film. As described further herein, layers  192 ,  192  may include an impermeable or semi-permeable, elastomeric material, as an illustrative, non-limiting example. In some implementations, compound film  152  may be liquid/gas (e.g., moisture/vapor) impermeable or semi-permeable. 
     Compound film  152  is configured to be separable. In the example illustrated in  FIG. 1B , the first layer  192  is a removable protective film, also referred to as a light blocking layer, and the second layer  194  is a non-light blocking layer (e.g., a light transmitting or passing layer). As compared to conventional compound films for conventional light switchable adhesives (e.g., two phase LSA), the compound films  152  described herein may include an additional protective film or light blocking layer corresponding to a second type of light (e.g., different light from the first type of light), such as to filter or block the first light  132  and/or the second light  136 . 
     Additionally, one or more layers  192 ,  194  of the compound film  152  are further configured to transmit or allow the passage of fluid. Such films may include a relatively high moisture transfer capability, such as a moisture vapor transfer rate of (MVTR) of greater than 250 g/m 2 . Alternatively, such films may be moisture wicking (e.g., absorb or draw fluids by capillary action). In some such implementations where the DSA  110  is configured to (designed to) have a moisture based transition from the first  142  phase to the second phase  144 , both layers  192 ,  194  may be configured to transmit or allow the passage of fluid, such as water. 
     In some implementations, the first layer  192  of the compound film  152  described herein may be configured to block light of multiple different spectrums, such as to filter or block the first light  132  and the second light  136 . Additionally, in such implementations, the second layer  194  of the compound films  152  described herein may be configured to pass or transmit light of multiple different spectrums, such as the first light  132  and the second light  136 . Accordingly, the compound film  152  supports blocking and receiving multiple types of light to control activation of the photo initiators  122  of the DSA  110 . 
     As illustrated in the example of  FIG. 1B , the first layer  192  is in direct contact with the second layer  194 , and the DSA  110  is in direct contact with the second layer  194 . That is, compound film  152  does not include a handing or support layer or an adhesive layer between the first layer  192  and the second layer  194 . In conventional light switchable adhesives, which are often thinner and less viscous, a support or handling layer is included in a compound film to provide handling of the compound film including the conventional light switchable adhesive during production, transportation, attachment, or a combination thereof. In a particular implementation, first layer  192  includes a tab (e.g.,  544 ) to enable easy removal of the first layer  192  from the compound film  152 . The tab may extend outwards and/or upwards from the compound film  152  to facilitate removal or first layer  192  from second layer  194 . 
     First layer  192  is configured to be removed from second layer  194  while second layer  194  is bonded to a bond site, such as a tissue site (e.g.,  520 ,  720 ). First layer  192  is configured to block or filter light of a particular wavelength associated with transitioning the DSA  110  from the first phase  142  to the second phase  144 , and second layer  194  is configured to pass or transmit the light of the particular wavelength associated with transitioning the DSA  110  from the second phase  144  to the third phase  146 . For example, the first layer  192  may be configured to block or filter UV light wavelengths, visible light wavelengths, or both and/or the second layer  194  may be configured to pass UV light wavelengths, visible light wavelengths, or both. To illustrate, the first layer  192  is configured to block or filter light having a wavelength between 10 nanometers and 500 nanometers and/or the second layer  194  is configured to pass light having a wavelength between 10 nanometers and 500 nanometers. In other implementations, the light which is blocked or filtered by the first layer  192  and/or passed by second layer  194  includes or corresponds to visible light, a portion of the visible light spectrum, UV light, a portion of the UV light spectrum, or a combination thereof. In a particular implementation, the first layer  192  is opaque and the second layer  194  is optically transparent. To illustrate, the first layer  192  blocks visible light and the second layer  194  passes a majority to all of visible light (with or without diffusion). 
     In a particular implementation, first layer  192  and second layer  194  are configured to be permeable to air and water vapor, to enable tissue of tissue site to which the compound film  152  is bonded to “breathe.” First layer  192  and second layer  194  of compound film  152  may include an impermeable or semi-permeable, elastomeric material, as an illustrative, non-limiting example. In some implementations, first layer  192  and/or second layer  194  are liquid/gas (e.g., moisture/vapor) impermeable or semi-permeable. Additionally, or alternatively, first layer  192  and/or second layer  194  include or are elastomeric material. “Elastomeric” means having the properties of an elastomer. For example, elastomer generally refers to a polymeric material that may have rubber-like properties. More specifically, an elastomer may typically have ultimate elongations greater than or equal to 100% and a significant amount of resilience. The resilience of a material refers to the material&#39;s ability to recover from an elastic deformation. Elastomers that are relatively less resilient may also be used as these elastomers. Examples of elastomers may include, but are not limited to, natural rubbers, polyisoprene, styrene butadiene rubber, chloroprene rubber, polybutadiene, nitrile rubber, butyl rubber, ethylene propylene rubber, ethylene propylene diene monomer, chlorosulfonated polyethylene, polysulfide rubber, polyurethane (PU), EVA film, co-polyester, and silicones. 
     In some implementations, second layer  194  is configured to diffuse light to DSA  110 , such as light received from a top (e.g., when first layer  192  is removed) and/or a side of second layer  194 . To illustrate, light (e.g.,  132  and/or  136 ) received on a side of second layer  194  is scattered as it passes through second layer  194  to distribute the light to the DSA  110 . Additionally, or alternatively, second layer  194  may be formed of a thin, clear, flexible, breathable material with a high refractive index. One exemplary material for the second layer  194  is polyurethane (PU). 
     DSA  110  may be applied to or disposed on second layer  194  after compound film  152  is formed, as described with reference to  FIG. 8 . In some implementations, DSA  110  is a coating or a pattern of coatings, as described further herein. Alternatively, DSA  110  may be formed with one or more films of the compound film  152 , such as co-extruded with second layer  194 . 
     Compound film  152  may be configured to couple a bandage, a wound closure device, a dressing, and/or a drape, to provide a seal to create an enclosed space (e.g., an interior volume) corresponding to a tissue site. For example, compound film  152  may be configured to provide a fluid seal (i.e., provide a portion of fluid seal) between two components and/or two environments, such as between a sealed therapeutic environment and a local ambient environment. To illustrate, when coupled to a tissue site, compound film  152  is configured to maintain a pressure differential at the tissue site and/or keep fluids from permeating through the compound film  152 , as described further with reference to  FIG. 7A . 
     In some implementations, DSA  110  has or is configured to provide a bond strength (e.g., peel strength) for the compound film  152  of at least at or greater than, or substantially equal to any one of, or between two of: 3, 4, 5, 6, 8, 10, 12, 14, 16, 18, or 20 N, in the second phase  144 . The bond may be formed by DSA  110  between second layer  194  and a bond site, such as target tissue of a tissue site. To illustrate, DSA  110  may have a bond strength as described above or may be applied such that compound film  152  has a bond strength as described above, such as when DSA  110  is patterned on compound film  152 . In some implementations, the bond strength of the DSA  110  increases after application of DSA  110  to the bond site (e.g., tissue site). For example, the bond strength of the DSA  110  may achieve (e.g., reach) a maximum bond strength between 30 minutes to 24 hours after application. Additionally, or alternatively, DSA  110  has or is configured to provide a bond strength (e.g., peel strength) at least at or greater than, or substantially equal to any one of, or between two of: 0.3, 0.5, 1, 2, 3, 4, 5, 6, 8, or 10 N, in the third phase  146  after being exposed to first light  132  or second light  136 . The peel strength values for DSA  110 /compound film  152  or bond strength of DSA  110 /compound film  152  are described in terms of a peel strength as measured by a 180 degree peel test on stainless steel. The peel strength values for DSA  110 /compound film  152  or bond strength of DSA  110 /compound film  152  may be indicative of a bond strength with human tissue at a particular time, such as two hours after application of DSA  110 /compound film  152 . 
     The compound film  152  may be post processed as described further herein. For example, the compound film  152  may be perforated and/or may be coupled, bonded to, or compound with one or more additional films or layers. In some implementations, a dual switchable adhesive is applied to compound film  152 , as described further with reference to  FIG. 8 . 
     As described above, layers  192 ,  194  of compound film  152  are removable/separable, i.e. are designed to be removed from each other during operation of the compound film  152 . An example of operation of a compound film including a DSA  110  is described further with reference to  FIGS. 5A-5D . 
     In some implementations, a dual switchable adhesive (e.g., three or more phase dual switchable adhesive) includes one or more polymers; polymerization initiators configured to cause the one or more polymers to cross-link responsive to receiving moisture; and photo initiators configured to cause the one or more polymers to cross-link responsive to receiving light. 
     In a particular implementation, the dual switchable adhesive has at least three states, each state corresponding to a particular peel strength, and wherein the dual switchable adhesive is configured to transition between a first two states of the three states based on activation of the polymerization initiators and to transition between a second two states of the three states based on activation of the photo initiators. Additionally or alternatively, the dual switchable adhesive has a second peel strength in the second state that is greater than a first peel strength of the dual switchable adhesive in the first state, and wherein a third peel strength of the dual switchable adhesive in the third state is less than the second peel strength. 
     In other implementations, the dual switchable adhesive is configured to transition between a first two states of the three states based on activation of the photo initiators and to transition between a second two states of the three states based on activation of the polymerization initiators. 
     In some implementations, the dual switchable adhesive is included in a compound film. In a particular implementation, a compound film includes a first layer of a first polymer composition; a second layer of a second polymer composition, the second layer removeably coupled to the first layer; and a dual switchable adhesive, such as the dual switchable adhesive described above. 
     Thus, system  100  describes an improved dual switchable adhesive. The dual switchable adhesive described herein, such as DSA  110 , include additional phases and may have a low tact/peel strength first phase for easier use. Therefore, DSA  110  is suitable for use in medical devices, such as bandages, drapes, dressings, and wound closures. DSA  110  enables medical devices to be repositionable, thereby avoiding or limiting waste from inadvertent contact and misplacement and avoiding or limiting tissue damage at tissue site and patient discomfort from repositioning. Accordingly, DSA  110  may enable improved wound care and therapy, thereby advancing patient comfort and confidence in the treatment. 
       FIG. 2A  illustrates an illustrative chemical reaction process for an exemplary curing initiator, such as photo initiators  122  or polymerization initiators  124 .  FIG. 2A  illustrates free-radical polymerization (FRP) reactions. FRP is a method of polymerization (chain-growth polymerization) by which a polymer forms or increases in chain length by the successive addition of free-radical building blocks. In DSA (e.g.,  110 ), the free radicals are formed by the polymerization initiators receiving moisture or light. The free radical adds (nonradical) monomer units to an existing polymer chain, thereby growing the polymer chain. 
     Different types of polymerization initiators generate different types of free radicals. As an illustrative example, a free radical is created by breaking an oxygen-oxygen bond (O—O bond) in a peroxide, such as benzoyl peroxide. Exemplary free radicals are capable of attacking an carbon-carbon double bound (C═C bond), such as an olefinic double bond of a vinyl monomer. 
     The free radical is then transferred to the monomer, forming an active center that can attach to other monomers. This step is called propagation, in which the free radical is propagated down the polymer chain. The final step is termination, in which two molecules containing free radicals react and form the final product. 
     Monomer molecules add onto the active site of a growing polymer chain one at a time. Growth of the polymer occurs at the active sites on the chain, which are typically at the chain-end(s). The addition of each monomer unit to the growing polymer chain regenerates the active site, enabling an additional monomer unit to be added. In chain-growth polymerization, an activated species (initiator or active center) adds one monomer molecule to create a new active center (propagation step), which again adds another monomer molecule to create another active center and so on, so that the chain growth proceeds as a chemical chain reaction. 
     As illustrated in  FIG. 2A , a polymerization initiator (I 1 ) (e.g., a moisture based polymerization initiator) receives fluid and undergoes a chemical reaction to produce free radicals (R1). The fluid may be in the form of moisture, i.e., diffused liquid or gas. The free radicals (R1) bond with a carbon-carbon double bond (C═C) and in the process break one of the bonds of the carbon-carbon double bond. The newly formed carbon and free radical chain bonds with other chains including carbon-carbon double bonds. Chains having free radical ends bond to each other. Accordingly, the resulting reactions from the polymerization initiator receiving light increase a degree of cross-linking of the polymers of the DSA. 
     Additionally, or alternatively, step-growth polymerization (also referred to as polyaddition or polycondensation) may be initiated by a polymerization initiator (or another curing initiator. Step-growth polymerization is a method of polymerization by which a polymer forms or increases in chain length by the successive addition of functional groups. During step-growth polymerization, bi-functional or multifunctional monomers react to form first dimers, then trimers, longer oligomers and eventually long chain polymers. In polyaddition, the propagation steps are addition reactions and no molecules are evolved during these steps, and in polycondensation the propagation steps are condensation reactions and molecules are evolved during these steps. An Exemplary step-growth polymerizations are illustrated in  FIG. 3B  and  FIGS. 3C and 3D . In addition, chain-growth polymerization and step-growth polymerization reactions with respect to molecular weight are illustrated in  FIG. 4B . 
     Referring to  FIGS. 2B-2D , exemplary states of a DSA, such as DSA  110 , are illustrated in representative chemical form.  FIG. 2B  illustrates a first state or first phase (e.g.,  142 ) of the DSA that has a low level of cross-linking and unactivated polymerization initiators. As illustrated in  FIG. 2B , the DSA includes many short molecules including a carbon-carbon double bond (C═C). These molecules represent monomers or short polymer chains. The DSA also includes multiple types of polymerization initiator molecules, (I1, I2). 
       FIG. 2C  illustrates a second state or second phase (e.g.,  144 ) of DSA that has a medium level of cross-linking and unactivated polymerization initiators of a second type. As illustrated in  FIG. 2C , the DSA includes many medium molecules including a carbon-carbon single bond (C—C). These short molecules represent monomers or short polymer chains. The DSA includes only second polymerization initiator molecules (I2), as the first polymerization initiator molecules (I1) have been activated or used up when moisture  134  was applied to the DSA in the first state. The first polymerization initiator molecules (I1) may initiate chain-growth polymerization (e.g., free-radical polymerization) or step-growth polymerization. 
       FIG. 2D  illustrates a third state or third phase (e.g.,  146 ) of DSA that has a high level of cross-linking and no unactivated polymerization initiators. As illustrated in  FIG. 2D , the DSA includes a few longer polymer molecules including repeating monomers connected by a carbon-carbon single bond (C—C). The DSA also no longer includes any polymerization initiator molecules, (I1, I2), as the second polymerization initiator molecules (I2) have been activated or used up when second light was applied to the DSA in the second state. The second polymerization initiator molecules (I2) may initiate chain-growth polymerization (e.g., free-radical polymerization) or step-growth polymerization. Corresponding peel strengths and curing/cross-linking levels for each state may be illustrated in  FIG. 4A . 
       FIGS. 3A-3D  illustrate chemical formulas and reactions for exemplary curing systems of a DSA, such as DSA  110 .  FIGS. 3A and 3B  illustrate chemical formulas and reactions for a urethane acrylic dual cure system. The urethane acrylic dual cure system depicted in  FIGS. 3A and 3B  illustrates an acrylate cure mechanism with UV light and an isocyanate cure mechanism with water.  FIGS. 3C and 3D  illustrate chemical formulas and reactions for an alkoxy acrylic dual cure system. The alkoxy acrylic dual cure system depicted in  FIGS. 3C and 3D  illustrates an ethoxy cure mechanism with water. The alkoxy acrylic dual cure system depicted in  FIGS. 3C and 3D  may also utilize light curing, such as the acrylate cure mechanism with UV light illustrated in  FIG. 3A . 
     Referring to  FIG. 3A , an illustrative chemical reaction process for an exemplary UV curing is depicted as diagram  302 . An unsaturated acrylate group (R1)  324  reacts with UV light  332  to undergo chain-growth polymerization. As illustrated in  FIG. 3A , a polymer  312  (e.g., an unreacted polymer with respect to light and/or moisture curing) includes a polymer chain (represented by wavy line  342 ) that links urethane  322  (a urethane functional group, NHCO 2 ) with acrylate  324  (an unsaturated acrylate functional group, R1). In  FIG. 3A , polymer  312  includes or corresponds to urethane acrylate. After exposure to UV light  332 , the unsaturated acrylate functional group (R1)  324  polymerizes responsive to reactions caused by photo initiators (e.g.,  122 ). For example, the photo initiators generate free radicals and initiates chain-growth polymerization, as described with reference to  FIG. 2A . The acrylate functional group polymerizing corresponds to the acrylate functional group forming polymer chain links with other polymers. The polymer  312  is chemically changed into polymer  314  by UV light  332 . 
     As illustrated in  FIG. 3A , the polymers  312 ,  314  (urethane acrylate) include (e.g., is bonded to) one or more isocyanate groups  326 . As illustrated in  FIG. 3A , the urethane  322  is bonded to the one or more isocyanate groups  326  via one or more other atoms or molecules. The isocyanate groups  326  may include or correspond to polymerization initiators, such as polymerization initiators  124 . The isocyanate groups (e.g., polymerization initiators) may react with a solution to cure the polymer. The isocyanate groups may be activated prior to or after the light curing illustrated in  FIG. 3A  and activation of isocyanate groups  326  is described with reference to  FIG. 3B . 
     Referring to  FIG. 3B , an illustrative chemical reaction process for an exemplary polymerization initiator, an isocyanate functional group, is depicted as diagram  304 . In  FIG. 3B , an isocyanate group  326  (R—NCO) reacts with water  334  (H 2 O) to produce a polyurea  330 . As illustrated in  FIG. 3B , an amine (R—NH 2 )  328  functional group is produced and carbon dioxide (CO 2 ) is released. 
     Urea (aka carbamide) is an organic compound with the chemical formula (NH 2 ) 2 CO. The molecule has two amine groups (R—NH 2 ) joined by a carbonyl functional group (C═O). In a polyurea, alternating monomer units of isocyanates and amines may react with each other to form urea linkages. The reaction of the isocyanate  326  and water  334  forms a carbamic acid intermediate (not shown). This carbamic acid quickly decomposes by splitting off (releasing) carbon dioxide and leaving behind the amine  328 . This amine  328  then reacts with another isocyanate group  326  to form the polyurea  330  linkage. A simplified summary is also shown to illustrated that the isocyanate  326  and water  334  produce a polyurea  330  linkage. 
     Referring to  FIGS. 3C and 3D  an illustrative chemical reaction process (Hydrolysis) for an exemplary polymerization initiator is depicted.  FIG. 3C  depicts a diagram  306  illustrating a first stage of the reaction and  FIG. 3D  depicts a diagram  308  illustrating a second stage of the reaction. In  FIG. 3C , a polymer  352  (e.g., an alkoxy acrylic polymer, such as an alkoxy silane functional acrylic) includes a silicon atom bonded to acrylate and ethoxy groups (represented by chains) via oxygen atoms. As illustrated in  FIG. 3C , the polymer  352  also includes an unsaturated acrylate group  362  (R1) bonded to the silicon atom which polymerizes under light and photo initiators, as described with reference to  FIG. 3A . An ethoxy group  366  (illustrated by alkoxy functional group, OR aka R—O) reacts with water  334  (H 2 O) to produce ethanol  368  (illustrated by alcohol functional group, R—OH) and a reacted polymer  354 . The reacted polymer  354  now includes a hydroxy group  370  coupled to the silicon atom instead of the ethoxy group  366 . The reacted polymer  354  may include a radical (R)  364  in place of the unsaturated acrylate group  362  (R1). As illustrated in  FIG. 3C , the radical (R)  364  may be an ethyl radical such as C 2 H 5 . 
     The ethanol  368  released may provide an added benefit of an antiseptic. To illustrate, the released ethanol  368  may migrate to a tissue site (e.g., skin) and may kill virus or bacteria (reduce a count thereof) on the skin and/or reduce or prevent formation of virus or bacteria (reduce or slow a growth rate thereof). The ethanol  368  may be absorbed into tissue of the tissue site and/or evaporated from the tissue without harm to the tissue or the tissue site. Additionally or alternatively, the released ethanol  368  may kill virus or bacteria (reduce a count of thereof) on the DSA or a component attached thereto and/or reduce or prevent formation of virus or bacteria (reduce or slow a growth rate thereof). 
     Referring to  FIG. 3D , two reacted polymers  354  join together, i.e., cross-link or undergo chain extension to form a longer chain polymer molecule  356 . In  FIG. 3D , the reacted polymers  354  release water  334  (H 2 O) when joining together, and the longer chain polymer molecule  356  includes acrylate and ethoxy groups (represented by chains). The water  334  is released by joining of the hydroxy groups  370  of the reacted polymers  354  and may be used to continue the reaction, i.e., to produce another reacted polymer  354  as illustrated in  FIG. 3C . Accordingly, the reactions may continue to increase cross-linking of the polymer molecules. 
     As illustrated in  FIG. 3D , the reacted polymers  354  join together (condense) to form a crosslinked polymer, such as a crosslinked acrylic siloxane (i.e., a silicone) and release water. Although  FIGS. 3C and 3D  describe the polymers as including ethoxy groups, the polymers may include methoxy groups which react with water in other implementations. 
     In some implementations, the longer chain polymer molecules  356  (crosslinked polymers) include an unsaturated acrylate group  362  (R1) which polymerizes under light and photo initiators. In other implementations, the unsaturated acrylate group  362  (R1) was previously attached to the polymers (unreacted polymers  352 ) and was polymerized as described with reference to  FIG. 3B . 
     In some implementations, the reactions illustrated in  FIGS. 3C and 3D  may utilize one or more catalysts (Z). For example, the reactions may be initiated or facilitated by one or more catalysts. As illustrated in  FIGS. 3C and 3D , a first catalyst  372  is used to facilitate the reaction of the unreacted polymer  352  with water  334 , and a second catalyst  374  is used to facilitate the reaction between reacted polymers  354 . As illustrative, non-limiting examples, the first catalyst  372 , the second catalyst  374 , or both may include or correspond to Organotin (e.g., compounds of tin bonded to a carbon or hydrocarbon), titanates (e.g., titanium oxide) or a combination thereof. 
     Referring to  FIG. 4A , an exemplary graph  400  illustrating peel strength of an exemplary DSA and a degree of cross-linking of the DSA is shown.  FIG. 4A  illustrates a line graph illustrating peel strength values on a y-axis (vertical axis) and cross-linking values on an x-axis (horizontal axis) for transitions of a DSA, i.e., from a first state to a second state and from the second state to the third state. As an illustrative example, cross-linking values or a degree of cross-linking may include or correspond to an acrylate double bond conversion percentage. In  FIG. 4A , four exemplary peel strengths (ps 1 -ps 4 ) and cross-linking degrees are illustrated at four corresponding times (t 1 -t 4 ). 
     At a first time, t 1 , the DSA is uncured or partially cured, is in the first state (e.g., first phase  142 ), and has a first peel strength, ps 1 . From t 1  to t 2 , the DSA undergoes a transition from the first state to the second state responsive to receiving first light and/or moisture. At a second time, t 2 , the DSA is partially cured, is in the second state (e.g., second phase  144 ), and has a second peel strength, ps 2 . From t 2  to t 3 , the DSA undergoes a transition from the second state to a third state responsive to receiving second light and/or moisture. At a third time, t 3 , the DSA is fully cured, is in the third state (e.g., third phase  146 ), and has a third peel strength, ps 3 . 
     Alternatively, the third state or fully cured state has a peel strength that is lower than the first peel strength. As illustrated in  FIG. 4A , in some implementations the DSA can be cured to have a fourth peel strength in the third state, such as by adding additional light or moisture. The fourth peel strength, ps 4 , corresponds to a fourth time, t 4 . 
     Graph  400  is an exemplary graph and the slopes (i.e. rate of change) of peel strength to degree of cross-linking is illustrative. The example slopes shown in  FIG. 4A  may be different from actual implementations of DSA and may differ based on which type of initiator is used. To illustrate, light/photo initiators may induce more cross-linking more quickly than moisture/polymerization initiators and thus, for example, a slope from t 1  to t 2  may be less than a slope from t 2  to t 3  or t 4 , as illustrated. As another illustration, IR light may induce more cross-linking more quickly than UV or visible light and thus, for example, a slope from t 1  to t 2  may be greater than a slope from t 2  to t 3  or t 4 . Also, the example slopes are illustrated as linear or constant change, i.e., no acceleration or deceleration in the reaction for clarity. In actual examples, the slopes are likely to change (curves as opposed to lines) as the reactions are likely to slow when concentrations of reaction components decrease. Additionally, different formulations of DSA may have different slopes from each other. To illustrate, moisture/UV formulations have different slopes from moisture/IR formulations. 
     Referring to  FIG. 4B , an exemplary graph  450  illustrating chain-growth polymerization and step-growth polymerization with respect to concentration and molecular weight is shown.  FIG. 4B  illustrates a line graphs that depicts the different polymerization processes for chain-growth and step-growth polymerization. As illustrated in  FIG. 4B , as chain-growth polymerization occurs (increases in concentration), the existing polymers and chains link together and the average molecular rate rises faster as compared to step-growth polymerization. This is caused by initial or more rapid cross-linking as compared to step-growth polymerization. In step-growth polymerization, cross-linking usually occurs after chain-extension. To illustrate, bi-functional or multifunctional monomers react to form first dimers, then trimers, longer oligomers and eventually long chain polymers, which are cross-linked or then cross-link. Thus, the average molecular weight goes up more slowly in step-growth polymerization as compared to chain-growth polymerization. 
       FIGS. 5A-5D  illustrates an example  500  of attaching and removing a compound film from a bond site, such as tissue  522 . As illustrated in  FIGS. 5A-5D , compound film  552  includes a first polymer layer  512 , a second polymer layer  514 , a DSA  596 , and an adhesive cover film  598 . Referring to  FIGS. 5A and 5B , an example of attaching a compound film  552  to tissue  522  is shown. Compound film  552  may include or correspond to compound film  152 . Layers  512 ,  514  may include or correspond to layers  192 ,  194 , and DSA  596  may include or correspond to DSA  110 . Tissue  522  may include or correspond to target tissue of a tissue site (e.g.,  720 ) of a patient. 
     Although  FIG. 5A  illustrates that the compound film  552  includes adhesive cover film  598 , the adhesive cover film  598  is optional and may not be included in some implementations. Adhesive cover film  598  (e.g., an adhesive cover layer) is positioned over or coupled to DSA  596  to protect DSA  596  from activation, i.e., receiving light and transitioning to between phases (e.g.,  192 - 196 ), and from dust or contamination. Adhesive cover film  598  is configured to be removed prior to application of compound film  552  to tissue  522 , and as such, adhesive cover film  598  has a lower peel strength or bond strength to the DSA  596  than a peel strength or bond strength between the DSA  596  and the second polymer layer  514  when the DSA  596  is in the first phase (e.g.,  192 ). Adhesive cover film  598  may be formed of a thin, clear, flexible, breathable material with a high refractive index. One exemplary material for adhesive cover film  598  is polyurethane (PU). 
       FIG. 5A  depicts a first state of compound film  552  prior to attachment to tissue  522  via DSA  596 .  FIG. 5B  depicts a second state of compound film  552  after attachment of compound film  552  to tissue  522  via DSA  596 . To attach compound film  552 , the adhesive cover film  598  is removed from compound film  552  and the compound film  552  is attached to tissue  522 . During attachment, compound film  552  may be repositioned, DSA  596  may be adjusted if unintended contact occurs, or a combination thereof. Additionally, DSA  596  may be worked into creases or surfaces of tissue  522  to create a strong, uniform bond. Once compound film  552  is in the desired position on tissue  522 , moisture  134  (e.g., ambient or environmental moisture) may initiate curing/cross-linking and to transition the DSA  596  from the first phase (e.g.,  142 ) to the second phase (e.g.,  144 ). Additionally, or alternatively, moisture  534  may be applied to initiate curing/cross-linking and to transition the DSA  596  from the first phase (e.g.,  142 ) to the second phase (e.g.,  144 ). 
     As illustrated in  FIG. 5B , moisture  134  from tissue site  522  is drawn into and penetrates the DSA  596  and the moisture  534  applied from moisture applicator  516 , such as moisture source  114 , penetrates both the first polymer layer  512  and the second polymer layer  514 . For example, the first polymer layer  512  and the second polymer layer  514  are permeable to fluids, such as water. Additionally, or alternatively, moisture  134  from the air may migrate to DSA  596  by penetrating one or more of the first polymer layer  512  and the second polymer layer  514  to initiate curing/cross-linking and to transition the DSA  596  from the first phase (e.g.,  142 ) to the second phase (e.g.,  144 ). In  FIG. 5B , a bond strength between the DSA  596  and tissue  522  increases responsive to the moisture  134  and/or moisture  534 , as described with reference to  FIG. 4A . 
     In other implementations, an additional polymer layer may be included to protect against a wavelength or wavelengths used to cure DSA  596  and transition DSA  596  from the first phase to the second phase. For example, when visible light is used to transition DSA  596  from the first phase to the second phase, a third polymer layer may be coupled to the first polymer layer  512  (i.e., opposite the second polymer layer  514 ), and the third polymer layer is removed after attaching the compound film  552  to tissue  522  via DSA  596  but prior to application of the moisture  134 . 
     Referring to  FIGS. 5C and 5D , an example of removing a compound film  552  from tissue  522  is shown.  FIG. 5C  depicts a third state of compound film  552  attached to tissue  522  via DSA  596 .  FIG. 5D  depicts a fourth state of compound film  552  during removal of compound film  552 . 
     Referring to  FIG. 5C , the first polymer layer  512  is removed from the second polymer layer  514  by a patient or care provider, and second light  194  is applied to compound film  552  to initiate further curing/cross-linking and transition the DSA  596  from the second phase (e.g.,  144 ) to the third phase (e.g.,  146 ). In  FIG. 5C , a bond strength between the DSA  596  and tissue  522  decreases responsive to the first light  132  (or the second light  136 ). Thus, a bond strength between the DSA  596  and tissue  522  in  FIG. 5C  after receiving first light  132  (or the second light  136 ) is less than the bond strength between the DSA  596  and tissue  522  in  FIG. 5B  (after receiving the first light  132 ). 
     Referring to  FIG. 5D , the second polymer layer  514 , and optionally the DSA  596 , is/are removed from the tissue  522  by a patient or care provider. In  FIG. 5D , because the peel strength between the DSA  596  and the tissue  522  is less than a peel strength between the DSA  596  and the second polymer layer  514 , the second polymer layer  514  and the DSA  596  detach from tissue  522 . Additionally, because of the reduced peel strength of the DSA  596  in the third phase, the DSA  596  (and second polymer layer  514 ) may be removed from the tissue  522  without damage and pain. 
     In some implementations, a peel strength between the first polymer layer  512  and the second polymer layer  514  is between a peel strength of the DSA in the first phase and a peel strength of the DSA in the second phase, such as 4 N/25 mm to 8 N/25 mm. In a particular implementation, a peel strength between the first polymer layer  512  and the second polymer layer  514  is between 6 N/25 mm to 8 N/25 mm. Additionally, or alternatively, a peel strength between the second polymer layer  514  and the DSA  596  is greater than 4 N/25 mm. To illustrate, when DSA  596  is applied or disposed on the second polymer layer  514 , the DSA  596  forms a bond with the second polymer layer  514  having a peel strength is greater than 3 N/25 mm in the first phase. In a particular implementation, a peel strength between the second polymer layer  514  and the DSA  596  is greater than 8 N/25 mm. 
     In some implementations, the DSA  596  is configured to have a peel strength of less than 6 N/25 mm between the DSA  596  and a tissue  522  prior to being cured, i.e., in the first phase. In a particular implementation, the DSA  596  is configured to generate a peel strength of 2 N/25 mm to 6 N/25 mm or of less than 4 N/25 mm between the DSA  596  and a tissue  522  prior to being cured. Additionally, or alternatively, the DSA  596  is configured to form a bond between the DSA  596  and a tissue  522  having a peel strength of less than 6 N/25 mm. 
     In some implementations, the DSA  596  is configured to generate a peel strength of greater than 6 N/25 mm between the DSA  596  and a tissue  522  within 2 hours after curing of the DSA  596  attached to the tissue  522 . The tack level of the DSA  596  causes the DSA  596  to form a stronger bond with tissue  522  after application. Such a tack level allows for repositioning of the DSA  596  before the DSA  596  generates its maximum or operational bond strength. Adhesive cover film  598  may protect DSA  596  from dust and/or debris and enable easier handling to ensure that DSA  596  forms its maximum or operating bond. In a particular implementation, the DSA  596  is configured to generate a peel strength of 6 N/25 mm to 8 N/25 mm or of greater than 8 N/25 mm between the DSA  596  and a tissue  522  within 2 hours after curing of the DSA  596  attached to the tissue  522 . Additionally, or alternatively, the DSA  596  is configured to form a bond between the DSA  596  and a tissue  522  having a peel strength of greater than 6 N/25 mm. 
     In some implementations, compound film  552  includes a tab  544  to facilitate removal of first polymer layer  512  from the compound film  552  (e.g., second polymer layer  514  thereof). Additionally or alternatively, other features may be added to control or influence peel strength, facilitate separation of layers, and/or protection of DSA, i.e., activations of polymerization initiators thereof. Examples of such features include perforations in one or more layers of compound film  552 , as described with reference to U.S. Prov. Pat. App. No. 62/816,351, which is incorporated by reference in its entirety herein. Another example feature includes patterns of DSA, such as described with reference to U.S. Prov. Pat. App. No. 62/816,351. Such features may be used alone or in combination with other features described herein. 
       FIGS. 6A-6C  each illustrate a chemical formula for an exemplary photo initiator of a DSA, such as DSA  110  or DSA  596 . Referring to  FIG. 6A , a first chemical formula of a first photo initiator  622 A is depicted. The first photo initiator  622 A includes or corresponds to H-Nu-IR 780. The first photo initiator  622 A may include or correspond to the photo initiators  122 . 
     Referring to  FIG. 6B , a second chemical formula of a second photo initiator  622 B is depicted. The second photo initiator second includes or corresponds to H-Nu-IR 815. The second photo initiator  622 B may include or correspond to the photo initiators  122 . Thus, the first and second photo initiators  622 A,  622 B may be referred to as first type photo initiators  622 A,  622 B, and may be activated by similar wavelengths. 
     Referring to  FIG. 6C , a third chemical formula is illustrated for a third photo initiator  624 . The third photo initiator  624  is or includes Bis(2,4,6, trimethylbenzoyl)-phenylphosphineoxide. In a particular example, the third photo initiator  624  has a molecular weight of 418.5 and correspond to Irgacure 819. The third photo initiator  624  may include or correspond to the photo initiators  122 . The third photo initiator  624  may be referred to as a second type photo initiator and different from the first type photo initiators (e.g.,  622 A,  622 B). 
     In some implementations, first type photo initiators  622 A,  622 B have a concentration (e.g., weight percentage) of 0.05 to 3 percent of the total weight of the DSA (polymer composition). In a particular implementation, the first type photo initiators  622 A,  622 B have a concentration (e.g., weight percentage) of 0.1 to 1 percent of the total weight of the DSA (polymer composition). 
     Additionally, or alternatively, the second type photo initiators  624  have a concentration (e.g., weight percentage) of 0.5 to 8 percent of the total weight of the DSA (polymer composition). In a particular implementation, the second type photo initiators  624  have a concentration (e.g., weight percentage) of 1 to 4 percent of the total weight of the DSA (polymer composition). 
     In such implementations where a co-initiator or co-initiators are used, a first co-initiator for the first type photo initiators  622 A,  622 B may have a concentration (e.g., weight percentage) of 0.05 to 6 percent of the total weight of the DSA (polymer composition). In a particular implementation, the first co-initiator has a concentration (e.g., weight percentage) of 0.1 to 1 percent of the total weight of the DSA (polymer composition). As an illustrative, non-limiting example, a Borate V (from Spectra Group Limited) co-initiator may have a 1:1 ratio (mass concentration) with the first photo initiators. 
     Additionally, or alternatively, a second co-initiator for the second type photo initiators  624  may have a concentration (e.g., weight percentage) of 0.05 to 3 percent of the total weight of the DSA (polymer composition). In a particular implementation, the second co-initiator has a concentration (e.g., weight percentage) of 0.1 to 1 percent of the total weight of the DSA (polymer composition). As an illustrative, non-limiting example, an Irgacure 184 co-initiator may have a ratio (mass concentration) of 1:1 to 1:4 with the second type photo initiators  624 . 
     In some implementation, a solvent may be added to the DSA (polymer composition) increase solubility of a photo initiator, a co-initiator, or both. For example, the DSA (polymer composition) has 2 to 3 percent by weight of DMAA and/or ketones, individually or in total. 
       FIG. 7A  shows a perspective view of an illustrative system  700  (e.g., a therapy system) for providing wound therapy. System  700  may include a dual switchable adhesive, such as DSA  110 , a therapy device  710 , a canister  712 , a tube  714 , a dressing  716 , a light source  718  (e.g., a UV device or a dual light device), and a moisture applicator  719 . As an illustrative example, system  700  includes DSA  110  as part of dressing  716  (e.g., drape  732  thereof). For example, DSA  110  is attached to a drape layer  794  of drape  732 . The drape  732  includes a protective film  792  removably coupled to the drape layer  794  opposite the DSA  110 , and the protective film  792  and drape layer  794  correspond to a compound film  752 . 
     System  700  is configured to provide therapy (e.g., oxygen therapy, positive-pressure therapy, negative-pressure therapy, or a combination thereof) at a tissue site  720  associated with a target area of a patient. For example, dressing  716  may be in fluid communication with tissue site  720  and may be in fluid communication with therapy device  710  via tube  714 . In some implementations, system  700  may include one or more components commercially available through and/or from KCI USA, Inc. of San Antonio, Tex., U.S.A., and/or its subsidiary and related companies (collectively, “KCI”). 
     Therapy device  710  (e.g., a treatment apparatus) is configured to provide therapy to tissue site  720  via tube  714  and dressing  716 . For example, therapy device  710  may include a pressure source (e.g., a negative-pressure source, such as a pump, or a positive-pressure source, such as a pressurized oxygen container, an oxygen concentrator, or an oxygen collector) configured to be actuatable (and/or actuated) to apply pressure differential relative to ambient conditions to dressing  716 . As illustrative, non-limiting examples, positive-pressure applied to a tissue site may typically ranges between 5 millimeters mercury (mm Hg) (667 pascals (Pa)) and 30 mm Hg (4.00 kilo (k) Pa). Common therapeutic ranges are between 10 mm Hg (1.33 kPa) and 25 mm Hg (3.33 kPa). As illustrative, non-limiting examples, reduced-pressure applied to a tissue site may typically ranges between −5 millimeters mercury (mm Hg) (−667 pascals (Pa)) and −500 mm Hg (−66.7 kilo (k) Pa). Common therapeutic ranges are between −75 mm Hg (−9.9 kPa) and −300 mm Hg (−39.9 kPa). 
     In some implementations, therapy device  710  may alternate between providing positive-pressure therapy and negative-pressure therapy to the dressing  716 , may provide positive-pressure therapy to a first portion of the dressing  716  and negative-pressure therapy to a second portion of the dressing  716 , may provide no positive or negative pressure, or a combination thereof. In some such implementations, the therapy device  710  can provide positive-pressure therapy and negative-pressure therapy to the dressing  716  at the same time (e.g., partially concurrently). 
     As illustrated in  FIG. 7A , therapy device  710  includes canister  712  to receive fluid from tissue site  720  or to provide fluid to tissue site  720 . Although canister  712  is illustrated as being internal to and/or integrated with therapy device  710 , in other implementations, canister  712  is external to therapy device  710 , as illustrated and described with reference to  FIG. 1A . 
     Therapy device  710  may also include one or more other components, such as a sensor, a processing unit (e.g., a processor), an alarm indicator, a memory, a database, software, a display device, a user interface, a regulator, and/or another component, that further facilitate positive-pressure therapy. Additionally, or alternatively, therapy device  710  may be configured to receive fluid, exudate, and or the like via dressing  716  and tube  714 . Therapy device  710  may include one or connectors, such as a representative connector  738 . Connector  730  is configured to be coupled to tube  714 . Additionally, or alternatively, therapy device  710  may include one or more sensors, such a pressure sensor (e.g., a pressure transducer). The one or more sensors may be configured to enable therapy device  710  to monitor and/or sense a pressure associated with tube  714  and/or dressing  716 . 
     Tube  714  includes one or more lumens (e.g., one or more through conduits), such as a single lumen conduit or multiple single-lumen conduits. Tube  714  (e.g., a least one of the one or more lumens) is configured to enable fluid communication between therapy device  710  and dressing  716 . For example, fluid(s) and/or exudate can be communicated between therapy device  710  and dressing  716 , and/or one or more pressure differentials (e.g., positive-pressure, negative pressure, or both) can be applied by therapy device  710  to dressing  716 . As an illustrative, non-limiting illustration, tube  714  is configured to deliver at least pressurized oxygen from therapy device  710  to dressing  716  to establish positive-pressure. Communication of fluid(s) and application of a pressure differential can occur separately and/or concurrently. 
     In some implementations, tube  714  may include multiple lumens, such as a primary lumen (e.g., a positive-pressure/fluid lumen) for application of positive-pressure and/or communication of fluid, and one or more secondary lumens proximate to or around the primary lumen. The one or more secondary lumens (e.g., one or more ancillary/peripheral lumens) may be coupled to one or more sensors (of therapy device  710 ), coupled to one or more valves, as an illustrative, non-limiting example. Although tube  714  is described as a single tube, in other implementations, system  700  may include multiple tubes, such as multiple distinct tubes coupled to therapy device  710 , dressing  716 , or both. 
     As used herein, a “tube” broadly refers to a tube, pipe, hose, conduit, or other structure with one or more lumens adapted to convey fluid, exudate, and/or the like, between two ends. In some implementations, a tube may be an elongated, cylindrical structure with some flexibility; however, a tube is not limited to such a structure. Accordingly, tube may be understood to include a multiple geometries and rigidity. Tube  714  includes one or more lumens (e.g., one or more through conduits), such as a single lumen conduit or multiple single-lumen conduits. Tube  714  (e.g., a least one of the one or more lumens) is configured to enable fluid communication between therapy device  710  and dressing  716 . For example, fluid(s) and/or exudate can be communicated between therapy device  710  and dressing  716 , and/or one or more pressure differentials (e.g., positive-pressure, negative pressure, or both) can be applied by therapy device  710  to dressing  716 . As an illustrative, non-limiting illustration, tube  714  is configured to deliver at least pressurized oxygen from therapy device  710  to dressing  716  to establish positive-pressure. Communication of fluid(s) and application of a pressure differential can occur separately and/or concurrently. 
     Dressing  716  includes a connector  730  (also referred to as a dressing connection pad or a pad), a drape  732 , and a manifold  734  (also referred to as a distribution manifold or an insert). Drape  732  may be coupled to connector  730 . To illustrate, drape  732  may be coupled to connector  730  via an adhesive, a separate adhesive drape over at least a portion of connector  730  and at least a portion of drape  732 , or a combination thereof, as illustrative, non-limiting examples. 
     Drape  732  may be configured to couple dressing  716  at tissue site  720  and/or to provide a seal to create an enclosed space (e.g., an interior volume) corresponding to tissue site  720 . For example, drape  732  may be configured to provide a fluid seal between two components and/or two environments, such as between a sealed therapeutic environment and a local ambient environment. To illustrate, when coupled to tissue site  720 , drape  732  is configured to maintain a pressure differential (provided by a positive-pressure source or a negative-pressure source) at tissue site  720 . Drape  732  may include a drape aperture that extends through drape  732  to enable fluid communication between device and target tissue. Drape  732  may be configured to be coupled to tissue site  720  via an adhesive, such as a medically acceptable, pressure-sensitive adhesive that extends about a periphery, a portion, or an entirety of drape  732 . Additionally, or alternatively, drape  732  may be coupled to tissue site  720  via a double-sided drape tape, paste, hydrocolloid, hydrogel, and/or other sealing device or element, as illustrative, non-limiting examples. 
     Drape  732  may include an impermeable or semi-permeable, elastomeric material, as an illustrative, non-limiting example. In some implementations, drape  732  may be liquid/gas (e.g., moisture/vapor) impermeable or semi-permeable. Examples of elastomers may include, but are not limited to, natural rubbers, polyisoprene, styrene butadiene rubber, chloroprene rubber, polybutadiene, nitrile rubber, butyl rubber, ethylene propylene rubber, ethylene propylene diene monomer, chlorosulfonated polyethylene, polysulfide rubber, polyurethane (PU), EVA film, co-polyester, and silicones. In some implementations, drape  732  may include the “V.A.C.® Drape” commercially available from KCI. Additional, specific non-limiting examples of materials of drape  732  may include a silicone drape, 3M Tegaderm® drape, and a polyurethane (PU) drape such as one available from Avery Dennison Corporation of Pasadena, Calif. An additional, specific non-limiting example of a material of the drape  732  may include a 30 micrometers (μm) matt polyurethane film such as the Inspire™ 2317 manufactured by Exopack™ Advanced Coatings of Matthews, N.C. 
     Referring to  FIG. 7B , drape  732  includes or comprises a compound film  752  coupled to tissue site  720  by DSA  110 . The compound film  752  of drape  732  includes a protective film  792  and a drape layer  794 . A layer or coating of DSA  110  is bonded to drape layer  794 . Protective film  792  may include or correspond to first layer  192  or first polymer layer  412 . Drape layer  794  may include or correspond to second layer  194  or second polymer layer  414 . In some implementations, drape  732  includes DSA  110  on only a portion of the compound film  752 , such as a portion of the compound film  752  about a periphery of the drape  732 . 
     Referring to  FIG. 7A , manifold  734  is configured to be positioned on and/or near tissue site  720 , and may be secured at the tissue site  720 , such as secured by drape  732 . The term “manifold” as used herein generally refers to a substance or structure that may be provided to assist in applying a pressure differential (e.g., positive-pressure differential) to, delivering fluids to, or removing fluids and/or exudate from a tissue site and/or target tissue. The manifold typically includes a plurality of flow channels or pathways that distribute fluids provided to and removed from the tissue site. In an illustrative implementation, the flow channels or pathways are interconnected to improve distribution of fluids provided to or removed from the tissue site. Manifold  734  may be a biocompatible material that may be capable of being placed in contact with the tissue site and distributing positive and/or negative-pressure to the tissue site. Manifold  734  may include, without limitation, devices that have structural elements arranged to form flow channels, such as foam, cellular foam, open-cell foam, porous tissue collections, liquids, gels, and/or a foam that includes, or cures to include, flow channels, as illustrative, non-limiting examples. Additionally, or alternatively, manifold may include polyethylene, a polyolefin, a polyether, polyurethane, a co-polyester, a copolymer thereof, a combination thereof, or a blend thereof. 
     In some implementations, manifold  734  is porous and may be made from foam, gauze, felted mat, or other material suited to a particular biological application. In a particular implementation, manifold  734  may be a porous foam and may include a plurality of interconnected cells or pores that act as flow channels. The foam (e.g., foam material) may be either hydrophobic or hydrophilic. As an illustrative, non-limiting example, the porous foam may be a polyurethane, open-cell, reticulated foam such as GranuFoam® material manufactured by Kinetic Concepts, Incorporated of San Antonio, Tex. 
     In some implementations, manifold  734  is also used to distribute fluids such as medications, antibacterials, growth factors, and other solutions to the tissue site. Other layers may be included in or on manifold  734 , such as absorptive materials, wicking materials, hydrophobic materials, and hydrophilic materials. In an implementation in which the manifold  734  includes a hydrophilic material, manifold  734  may be configured to wick fluid away from tissue site  720  and to distribute positive-pressure to tissue site  720 . The wicking properties of manifold  734  may draw fluid away from the tissue site  720  by capillary flow or other wicking mechanisms. An illustrative, non-limiting example of a hydrophilic foam is a polyvinyl alcohol, open-cell foam such as V.A.C. WhiteFoam® dressing available from Kinetic Concepts, Inc. of San Antonio, Tex. Other hydrophilic foams may include those made from polyether and/or foams that have been treated or coated to provide hydrophilicity. 
     In some implementations, manifold  734  is constructed from bioresorbable materials that do not have to be removed from tissue site  720  following use of the system  700 . Suitable bioresorbable materials may include, without limitation, a polymeric blend of polylactic acid (PLA) and polyglycolic acid (PGA). The polymeric blend may also include without limitation polycarbonates, polyfumarates, and capralactones. Manifold  734  may further serve as a scaffold for new cell-growth, or a scaffold material may be used in conjunction with manifold  734  to promote cell-growth. A scaffold may be a substance or structure used to enhance or promote the growth of cells or formation of tissue, such as a three-dimensional porous structure that provides a template for cell growth. Illustrative examples of scaffold materials include calcium phosphate, collagen, PLA/PGA, coral hydroxy apatites, carbonates, or processed allograft materials. Although a manifold  734  is illustrated in  FIG. 7A , in other implementations, dressing  716  does not include manifold  734 . In such implementations, drape  732  of dressing  716  is coupled to connector  730 . 
     Connector  730  includes a body  742  (e.g., a housing) and a base  744 , and is configured to be coupled to tube  714  via an interface  746  (e.g., a port). Base  744  is configured to be coupled to dressing  716 . For example, base  744  may be coupled, such as via an adhesive, to drape  732  and/or manifold  734 . In some implementations, base  744  comprises a flange that is coupled to an end of body  742  and/or is integrally formed with body  742 . Connector  730 , such as body  742 , base  744 , interface  746 , or a combination thereof, may be made of rigid material and/or a semi-rigid material. In a non-limiting example, connector  730  may be made from a plasticized polyvinyl chloride (PVC), polyurethane, cyclic olefin copolymer elastomer, thermoplastic elastomer, poly acrylic, silicone polymer, or polyether block amide copolymer. In some implementations, connector  730  is formed of a semi-rigid material that is configured to expand when under a force, such as positive-pressure greater than or equal to a particular amount of pressure. Additionally or alternatively, connector  730  may be formed of a semi-rigid material that is configured to collapse when under a force, such as reduced-pressure less than or equal to a threshold pressure. 
     Body  742  includes one or more channels or one or more conduits that extend from and/or are coupled to interface  746 . To illustrate, body  742  may include a primary channel configured to be coupled in fluid communication with a primary lumen (e.g.,  721 ) of tube  714 . The primary channel may be coupled to a cavity (e.g., a tissue cavity partially defined by body  742 ) having an aperture open towards manifold  734  (and/or towards tissue site  720 ). For example, the primary channel may include a first opening associated with interface  746  and a second opening (distinct from the aperture of the cavity) associated with the cavity. Thus, the primary channel may define a through channel of body  742  to enable fluid communication between interface  746  and tissue site  720 . 
     Body  742  includes a channel (e.g., a through channel) having a first aperture open opposite dressing  716  and a second aperture open towards dressing  716 . For example, the first aperture is located on an outer surface side (e.g., an ambient environment surface) of connector  730  and the second aperture is located on an inner surface side (e.g., a tissue facing side) of connector  730 . The second aperture is configured to be coupled to one or more lumens of tube  714 , such as coupled via the cavity. Illustrative, non-limiting examples of commercially available connectors include a “V.A.C. T.R.A.C.® Pad,” or “Sensa T.R.A.C.® Pad” available from Kinetic Concepts, Inc. (KCI) of San Antonio, Tex. 
     In some implementations, dressing  716  further includes a bandage and/or a wound closure device  760 . For example, a bandage may be placed over a wound to protect the wound and a wound closure device  760  may be placed proximate to a wound to provide a force to maintain tissue in fixed position to promote wound closure. Each of the bandage and/or a wound closure device  760  may include compound film  752 . 
     Light source  718  is configured to provide light to activate DSA  110  (e.g., one or more type of photo initiators thereof) and cause DSA  110  to switch phases or states. Light source  718  may include or correspond to the Sun, ambient lighting, a dedicated light device, such as an IR torch, an UV torch device, visible light torch, a dual light torch, or a combination thereof. In a particular implementation, light source  718  is included in or integrated with therapy device  710 . In some such implementations, light source  718  provides light to drape  732  via tube  714 . 
     Moisture applicator  719  is configured to provide moisture (e.g.,  134 ,  534 ) to activate DSA  110  (e.g., one or more type of polymerization initiators thereof) and cause DSA  110  to switch phases or states. Moisture applicator  719  may include or correspond to a dedicated moisture application device, such as a wipe, a spray bottle, or a combination thereof. In a particular implementation, moisture applicator  719  is included in or integrated with therapy device  710 . In some such implementations, moisture applicator  719  moisture to drape  732  via tube  714 . 
     During operation of system  700 , dressing  716  is coupled to tissue site  720  over a wound. Additionally, dressing  716  is coupled to device  710  via tube  714 . In some implementations, prior to coupling the dressing  716  to the tissue site  720 , a bandage or a wound closure device  760  is coupled to tissue site  720  proximate to a wound. The dressing  716  is then coupled over the bandage or wound closure device  760 . One or more of the dressing  716  or over the bandage or wound closure device  760  is coupled to tissue site  720  site via compound film  752 . To illustrate, DSA  110  of the compound film  752  bonds the dressing  716 , the bandage or wound closure device  760 , or both to the tissue site  720  responsive to pressure. In a particular implementation when the compound film  752  is included in or corresponds to drape  732 , and the compound film  752  may seal a portion of tissue site  720 , such as an interior volume of dressing  716 . Moisture (e.g.,  134 ) is applied to the DSA  110  to partially cure the DSA  110  and transition the DSA  110  from a first phase (e.g.,  142 ) to a second phase (e.g.,  144 ), such as from a low tact/peel strength state to a high tact/peel strength state. 
     A pressure differential, such as positive-pressure, can be generated and/or applied to dressing  716  (e.g., the interior volume of dressing  716 ) by a pressure source associated with device  710 . When positive-pressure is generated and/or applied to dressing  716 , fluid or medication from device  710 , such as from canister  712 , may be transported to dressing  716 . Furthermore, in some implementations, reduced-pressure can be applied to dressing  716  (e.g., the interior volume of dressing  716  or a second interior volume of the dressing  716 ) by a reduced-pressure source associated with device  710 . When reduced-pressure is applied to dressing  716  (e.g., when vacuum pressure is generated, fluid, exudate, or other material within dressing  716  may be transported to canister  712  of device  710 . 
     After operation, such as completion of therapy, system  700  may be disconnected and components thereof removed from tissue site  720 . For example, protective film  792  of compound film  752  may be removed from drape layer  794  exposing DSA  110  thereof to light, such as ambient light or light (e.g.,  132  and/or  136 ) from a dedicated light device (e.g.,  112  or  114 ). The DSA  110  disposed on drape layer  794  may transition from the second phase (e.g.,  144 ) to the third phase (e.g.,  146 ). To illustrate, the DSA  110  transitions from the high tack/peel strength phase to a second low tack/peel strength phase by curing further (further increasing in cross-linking). Accordingly, drape  732 , and thus dressing  716 , can be easily removed from tissue site  720 . In some implementations where a bandage/wound closure device  760  is used and where the bandage/wound closure device  760  includes a compound film  752 , the DSA  110  can be activated by second light (e.g.,  134  or  136 ), such as UV light. To illustrate, the protective film  792  of the compound film  752  of the bandage/wound closure device  760  may be removed from drape layer  794  exposing DSA  110  to the second light. Similarly, the bandage/wound closure device  760  can be easily removed from tissue site  720 . 
     Thus, dressing  716 , bandage/wound closure device  760 , or both, can be adhered to a patient with a dual switchable adhesive in a low tack phase to be painlessly and easily repositioned. Accordingly, the dual switchable adhesive enables easier use and less waste, as compared to conventional light switchable adhesives with two phases or states. 
     Referring to  FIG. 8 , a block diagram of a manufacturing system, system  800 , for making DSA and components (e.g., compound films) including DSA, such as a coating thereof. In the example illustrated in  FIG. 8 , system  800  includes a control system  810 , a DSA processing system  812 , a DSA coating system  814 , and packaging system  816 . Control system  810  is configured to control one or more of systems  812 - 816 , as described further herein. 
     DSA processing system  812  includes one or more extruders  820 , one or more dies  822 , and optionally includes one or more heaters  824  (e.g., heating devices). DSA processing system  812  may include or correspond to melt blend extruder. DSA processing system  812  is configured to generate DSA  854  from one or more polymers  826 , photo initiators  828 , and polymerization initiators  830 . For example, DSA processing system  812  may be configured to generate DSA  854 , such as three phase DSA. DSA processing system  812  may include or correspond to an extrusion film system. For example, DSA processing system  812  receives or generates pellets or resin of one or more polymers  826  or receives a polymer composition (e.g., polymer composite) including one or more polymers  826 , and DSA processing system  812  produces extrudate of a polymer material based on the received polymer material. The extrudate may have the form of or may be formed into a film of polymer material (i.e., a polymer film of a polymer composition). The extrudate may correspond to DSA  854  or may be post processed into DSA  854 . As an illustrative example, DSA processing system  812  may include or correspond to a melt-compounding system or a melt-blend combiner. 
     DSA coating system  814  is configured to apply DSA  854  to or form a coating of DSA on a film, such as a compound film  852 . For example, DSA coating system  814  is configured to apply or selectively apply DSA  854  to compound film  852 . DSA coating system  814  includes an applicator  860  and DSA  854 . Applicator  860  may be configured to apply the DSA  854  to compound film  852  in a pattern, i.e., apply a pattern of DSA  854 . For example, applicator  860  selectively applies the DSA  854  according to patterns, as described with reference to  FIGS. 5A-5D , or applicator  860  applied a coating of DSA  854  and a removal device (e.g., a blade, a scraper, a wiper, a roller, etc.) selectively removes a portion of the coating. In some implementations, the applicator  860  is a die (e.g., a slot die), a roller, a patterned roller, a spray nozzle, etc. 
     DSA coating system  814  may optionally include one or more heaters  862 , curing devices  864 , mixing devices  866 , or a combination thereof. The one or more heaters  862  and mixing devices  866  may be configured to heat and mix DSA  854  prior to application and/or delivery to applicator  860 . The one or more curing device  864  may be configured to apply heat or light to the DSA  854  after application by the applicator  860 . The compound film  852  may include or correspond to compound film  152 , compound film  552 , or compound film  752 , and may be received from a film generation/lamination system. In a particular implementation, and as illustrated in  FIG. 8 , the compound film  852  is formed into or included into a drape  856 , such as drape  732 . 
     Packaging system  816  includes packing equipment  842  and is configured receive drapes  856  and package the drapes  856  for shipping and storage. For example, packaging system  816  is configured to insert one or more drapes  856  into a pouch  858 . In some implementation, packaging system  816  is further configured to insert or package one or more pouches  858  into a container or pallet. An illustrative example of a pouch is illustrated and described with reference to  FIG. 10 . 
     Packaging system  816  may optionally include sterilization equipment  844 , and in such implementations, packaging system  816  is configure to further sterilize the drapes  856 . The sterilization equipment  844  may be configured to apply a non-activating sterilizer (with respect to the DSA  854 ) or sterilization agent to the drapes  856  to sterilizes the drapes. The drapes  856  may be sterilized while in the pouches  858 . As an illustrative, non-limiting example, the pouches  858  are permeable to the sterilizing agent and the sterilizing agent does not activate the DSA  854  of the drapes  856 . In a particular implementation, the sterilization agent includes ethylene oxide. The ethylene oxide, or other sterilization agent, may be “dry” as in not mixed with water and/or used in conjunction with steam. The ethylene oxide may be provided to the pouches in a gaseous state. Conventional sterilization processes often use steam (i.e., water vapor) to open pores of the pouches  858  and/or drape  856  for penetration by the ethylene oxide. However, conventional sterilization processes which use water vapor cannot be used to sterilize the drapes  856  as it would activate the DSA  854 . 
     Although listed as separate systems, systems  812 - 816  may be incorporated into a single system. For example, DSA processing system  812  and DSA coating system  814  may be incorporated into a single system. Additionally, system  800  may include one or more other systems, such as a film or compound film generation system, a cover film lamination system, a post-processing system, a drape formation system, a sterilization system, or a combination thereof. The post-processing system may be configured to cut and/or form the compound film  852  into shapes and add features to the compound film  852 . For example, the post-processing system may modify the compound film to add tabs (e.g.,  544 ). 
     Control system  810  includes one or more interfaces  870 , one or more controllers, such as a representative controller  872 , and one or more input/output (I/O) devices  878 . Interfaces  870  may include a network interface and/or a device interface configured to be communicatively coupled to one or more other devices, such as DSA processing system  812  or DSA coating system  814 . For example, interfaces  870  may include a transmitter, a receiver, or a combination thereof (e.g., a transceiver), and may enable wired communication, wireless communication, or a combination thereof. Although control system  810  is described as a single electronic device, in other implementations system  800  includes multiple electronic devices. In such implementations, such as a distributed control system, the multiple electronic devices each control a sub-system of system  800 , such as DSA processing system  812 , DSA coating system  814 , or packaging system  816 . 
     The one or more controllers (e.g., controller  872 ) includes one or more processors and one or more memories, such as representative processor  874  and memory  876 . The one or more controllers may include or correspond to a DSA processing controller, a DSA application controller, a packaging controller, or a combination thereof. For example, DSA processing controller (e.g., processor  874 ) may be configured to generate and/or communicate one or more control signals  882  to DSA processing system  812 . DSA processing controller may be configured to control (or regulate) an environment, such as an air quality, temperature, and/or pressure, within DSA processing system  812  (e.g., an extruder thereof) and/or delivery/injection of materials into DSA processing system  812 . For example, DSA processing controller may be configured to generate and/or communicate one or more control signals  882 , such as environment control signals, ingredient delivery control signals, or a combination thereof, to DSA processing system  812 . 
     DSA application controller may be configured to control (or regulate) an environment, such as a temperature (e.g., heat) and/or pressure of DSA  854 , applicator  860 , or both, within DSA coating system  814  (e.g., applicator  860  thereof) and/or delivery/injection of DSA  854  into DSA coating system  814  (e.g., applicator  860  thereof). For example, application controller may be configured to generate and/or communicate one or more control signals  882 , such as environment control signals, ingredient delivery control signals, or a combination thereof, to DSA coating system  814 . 
     Packaging controller may be configured to control (or regulate) an environment, such as a temperature (e.g., heat) and/or pressure of DSA  854 , applicator  860 , or both, within packaging system  814  (e.g., packing equipment  842  and/or sterilization equipment  844  thereof). For example, packaging controller may be configured to generate and/or communicate one or more control signals  882 , such as environment control signals, ingredient delivery control signals, or a combination thereof, to packaging system  816 . 
     Memory  876 , such as a non-transitory computer-readable storage medium, may include volatile memory devices (e.g., random access memory (RAM) devices), nonvolatile memory devices (e.g., read-only memory (ROM) devices, programmable read-only memory, and flash memory), or both. Memory  876  may be configured to store instructions  892 , one or more thresholds  896 , and one or more data sets  898 . Instructions  892  (e.g., control logic) may be configured to, when executed by the one or more processors  874 , cause the processor(s)  874  to perform operations as described further here. For example, the one or more processors  874  may perform operations as described with reference to  FIGS. 1A, 1B, 5A-5D, 7, 8, and 10 . The one or more thresholds  896  and one or more data sets  898  may be configured to cause the processor(s)  874  to generate control signals. For example, the processors  874  may generate and send control signals responsive to receiving sensor data from one or more of systems  812 - 816 , such as exemplary sensor data  884  from DSA coating system  814 . The temperature or ingredient flow rate can be adjusted based on comparing sensor data to one or more thresholds  896 , one or more data sets  898 , or a combination thereof. 
     In some implementations, processor  874  may include or correspond to a microcontroller/microprocessor, a central processing unit (CPU), a field-programmable gate array (FPGA) device, an application-specific integrated circuits (ASIC), another hardware device, a firmware device, or any combination thereof. Processor  874  may be configured to execute instructions  892  to initiate or perform one or more operations described with reference to  FIG. 1A ,  FIG. 2 , and/or one more operations of the methods of  FIGS. 11, 13, 14, and 15 . 
     The one or more I/O devices  878  may include a mouse, a keyboard, a display device, the camera, other I/O devices, or a combination thereof. In some implementations, the processor(s)  874  generate and send control signals responsive to receiving one or more user inputs via the one or more I/O devices  878 . 
     Control system  810  may include or correspond to an electronic device such as a communications device, a mobile phone, a cellular phone, a satellite phone, a computer, a tablet, a portable computer, a display device, a media player, or a desktop computer. Additionally, or alternatively, the control system  810  may include a personal digital assistant (PDA), a monitor, a computer monitor, a television, any other device that includes a processor or that stores or retrieves data or computer instructions, or a combination thereof. 
     During operation of system  800 , DSA processing system  812  generates DSA  854 . For example, DSA processing system  812  generates DSA  854  by mixing one polymer(s)  826 , photo initiators  828 , and polymerization initiators  830 . To illustrate, controller  872  may send one or more control signals  882  to DSA processing system  812 . The control signals  882  may include signals configured to cause DSA processing system  812  to mix or blend polymer(s)  826  (e.g., resin or pellets thereof), and initiators  828 ,  830  to form a polymer composition or blend in extruder  820 . To illustrate, control system  810  may send one or more signals  882  (e.g., environment control signals) to DSA processing system  812  to adjust conditions (e.g., heat, pressure, air quality) of the DSA processing system  812  or conditions (e.g., viscosity, temperature, etc.) of the polymer composition. Additionally or alternatively, control system  810  may send one or more control signals  882  (e.g., ingredient delivery control signals) to DSA processing system  812  to adjust rates and or amounts of polymer(s)  826 , initiators  828 ,  830 , one or more additives (e.g.,  126 ), or a combination thereof. 
     In some implementations, heater  824  provides heat to extruder  820  or to polymer(s)  826  prior to delivery to the extruder  820 . The polymer composition or blend is extruded by extruder  820  via a die  822  to form extrudate. The extrudate may include or correspond to the DSA  854 . 
     After formation of DSA  854 , the DSA  854  is provided to DSA coating system  814  and DSA coating system  814  applies or forms a coating of DSA  854  on the compound film  852 . For example, DSA coating system  814  may form a coating or film of DSA  854  on the compound film  852  via selective application. To illustrate, control system  810  may send or more control signals to control delivery (e.g., application) of DSA  854  to applicator  860  of DSA coating system  814 , DSA  854  to compound film  852  via applicator  860 , or both. In other implementations, DSA coating system  814  forms the DSA  854  on the compound film  852  via selective removal. To illustrate, control system  810  may send or more control signals to control removal (e.g., scraping or removing) of DSA  854  from compound film  852 . 
     In some implementations, DSA coating system  814  may receive control signals  882  to control a heater  862  and/or a mixing device  866  to heat and/or mix the DSA  854  prior to delivery of DSA  854  to applicator  860 . Additionally, DSA coating system  814  may receive control signals  882  to control a curing device  864  to cure the DSA  854  applied to the compound film  852 . 
     After formation of application of DSA  854  to the compound film  852 , the compound film  852  may correspond to a drape  856  or may be further processed into a drape  856 . After formation of multiple drapes  856 , the drapes  856  may be packaged for shipping and/or storage by packaging system  816 . For example, packaging system  816  may receive a plurality of pouches  858  and may open the pouches  858  and insert one or more drapes  856  into the pouches  858 . The packaging system  816  may close and seal the pouches  858  after insertion of the one or more drapes  856 . In some implementations, the packaging system  816  further sterilizes the pouches  858 . In a particular implementation, the packaging system  816  sterilizes the drapes  856  while the drapes  856  are sealed in the pouches  858 . To illustrates, the packaging system  816  applies a sterilizing agent, such as “dry” gaseous ethylene oxide, to the pouches  858 . The ethylene oxides permeates through the pouch and sterilizes the drapes  856 . As the drapes  856  are sealed in the pouch, the drapes  856  remain sterilized until the pouch  858  is opened prior to use. 
     In other implementations, the pouch  858  includes a valve, window, or flap and the packaging system  816  sterilizes the one or more drapes  856  in the pouch  858  via the valve, window, or flap, and then seals (e.g., fully seals or seals and unsealed portion of the pouch  858 ) the drapes  856  within the pouch  858 . 
     In some implementations, packaging system  816  may receive control signals  882  to control the packing equipment  842  and/or the sterilization equipment  844 . For example, the control signals  882  may activate a heater of the packing equipment  842  to seal one or more pouches  858 . As another example, the control signals  882  may activate a pump of the sterilization equipment  844  to generate vacuum pressure within a chamber that includes the sealed pouches  858  and a valve of the sterilization equipment  844  to provide the sterilizing agent to the pouches  858 . 
     Thus, system  800  of  FIG. 8  produces dual switchable adhesives with three or more states or phases. Accordingly, the present disclosure enables manufacturing of a three or more phase dual switchable adhesives and inclusion of such dual switchable adhesives into products. 
     Referring to  FIG. 9 , a kit  900  for medical devices, such as a component of system  700 , is illustrated. Kit  900  includes DSA  910 . The DSA  910  may include or correspond to DSA  110 , DSA  596 , or DSA  854 . 
     In some implementations, DSA  910  is included in or on a compound film, such as compound film  150 , compound film  552 , a drape  732 , compound film  752 , compound film  852 , etc. As illustrated in  FIG. 9 , DSA  910  is includes in a drape  912 . In some such implementations, one or more drapes  912  are included in a pouch  914 , described further with reference to  FIG. 10 . Additionally, or alternatively, DSA  910  is included in a container (e.g., a tube of DSA) and kit  900  includes a DSA applicator. 
     In some implementations, kit  900  includes a light device  922 . The light device  922  may include or correspond to light device  112 , light source  116 , light source  718 , or a combination thereof. In a particular implementation, the light device  922  (i.e., a dual light device) includes a first light source  932  and a second light source  934 . The first light source  932  is configured to emit first light (e.g.,  132 ) to activate first photo initiators (e.g.,  122 ) of DSA  910 , and the second light source  934  is configured to emit second light (e.g.,  136 ) to activate second photo initiators (e.g.,  624 ) of DSA  910 . For example, the first light source  932  may include or correspond to light device  112 , and the second light source may include or correspond to light source  116 . 
     In some implementations, the light device  922  further includes a reference light source  936  configured to emit reference light. The reference light source  936  may provide an indication of one or more distances. For example, the reference light source  936  may produce a particular shape or object (e.g., be in focus) with the reference light when the reference light source  936  is at a particular distance that corresponds to providing a particular light from one of the light sources  932 ,  934 . As an illustrative example, the reference light source  936  includes two white light sources angled relative to one another such that the reference light emitted from each white light source converges at a particular distance. Accordingly, an operator of the light device  922  can determine a distance for application of first light, second light or both. 
     In a particular implementation, the light device  922  further includes a controller  942 , an indicator  944 , and a sensor  946  (e.g., light or distance sensor). The controller  942  is configured to receive sensor data from the sensor  946  and to provide an indication via the indicator  944  that indicates a distance between the light device  922  and a surface. The indication may be visual, auditory, or haptic based, and the indication may indicate a particular distance (e.g., show an actual distance) or may indicate when the determined distance is within a range of distance. 
     In some implementations, kit  900  further includes a moisture source or applicator (e.g.,  134 ,  516 ,  719 ). As illustrated in  FIG. 9 , the kit  900  includes a wipe  924 . Wipe  924  includes moisture and is configured to apply or transfer the moisture to the DSA  910  when in proximity to and/or when in contact with the DSA  910 . 
     Additionally, or alternatively, kit  900  further includes a light source (e.g., a second light device), one or more additional components  926 , or a combination thereof. The light source may include or correspond to a light source  116  or light source  718 . The one or more additional components  926  may include or correspond to a DSA applicator, gloves, antiseptic, medical adhesive, and/or other components. 
     In some implementations, kit  900  may include a package  902 . For example, package  902  may include a box, a bag, a container, or the like. Package  902  may include the DSA  910  and/or the light device  922 . In some implementations, package  902  may further include the light source, the one or more additional components  926 , or a combination thereof. Additionally, or alternatively, package  902  may include a packaging medium (e.g., packaging material), such as foam, paper, or the like. Thus,  FIG. 9  describes kit  900  for a medical device that is secured to a tissue site or together by DSA (e.g., three phase DSA). 
     Referring to  FIG. 10 , an example of a pouch  1002 , such a pouch  858  or  914 , configured to store drapes having moisture activated DSA (e.g.,  110 ,  596 , etc.) is illustrated. In  FIG. 10 , pouch  1002  includes a permeable material  1012  that is permeable to sterilizing agents  1032 , such as sterilizing gasses, such a non-water based or “dry” gasses (e.g., ethylene oxide). The permeable material  1012  may also be configured to be a moisture barrier from moisture, such as activating fluid  1034 , that would otherwise activate the DSA (such as polymerization initiators thereof). 
     In other implementations, the pouch  1002  includes a window or flap  1014  which can be opened or accessed to insert and/or remove a drape, to apply or remove sterilizing agents  1032 , or both. In a particular implementation, a portion or a section of the pouch  1002  includes the permeable material  1012 . This section, i.e., window or flap  1014 , can then be covered or removed to seal the pouch  1002 . In some implementations, the pouch  1002  includes one or more seals  1016 . For example, the pouch  1002  may include one or more adhesive seals on the window or flap. As another example, the pouch  1002  may include excess permeable material  1012  which may be sealed by application of heat, vibration, chemical, etc. 
     In some implementations, the pouch  1002  includes one or more valves  1018 . The one or more valves  1018  may be configured to release pressure, receive pressure, or both. To illustrate, the one or more valves  1018  may be configured to release fluid or air to relieve extra pressure (i.e., pressure above ambient pressure) that accumulates in the pouch  1002 , to receive more fluid or air to increase pressure within the pouch  1002 , or both. The one or more valves  1018  may include one way valves, or bi-directional valves, and the one or more valves  1018  may be configured to switch between open and closed based on a pressure within the pouch  1002 , ambient pressure, or both. In some such implementations, the one or more valves  1018  include filters, such as antimicrobial filters configured to reduce or prevent microorganisms (e.g., bacteria and/or viruses) from entering the pouch  1002 . 
     In some implementations, the permeable material  1012  is also configured to block or filter light, such as light that would otherwise activate the DSA of a drape to be inserted into the pouch  1002 . Alternatively, an optional moisture barrier layer or material  1022  is configured to block or filter the light. In other implementations, the packaging (e.g.,  902 , such as a cardboard box) for the pouch  1002  is configured to block light that would otherwise activate the DSA of the drape in the pouch  1002 . 
       FIG. 11  illustrates a method  1100  of manufacturing dual switchable adhesive. The method  1100  may be performed at or by system  800  (e.g., one or more of systems  812 - 816  thereof). Method  1100  includes providing polymerization initiators to one or more polymers, the polymerization initiators configured to increase a cross-linking of the one or more polymers responsive to receiving moisture, at  1110 . For example, the polymerization initiators may include or correspond to polymerization initiators  124  or polymerization initiators  830 , and the one or more polymers may include or correspond to one or more polymers  120 . The moisture may include or correspond to moisture  134  or moisture  534 . 
     Method  1100  also includes providing photo initiators to the one or more polymers, the photo initiators configured to increase the cross-linking of the one or more polymers responsive to receiving light, at  1112 . For example, the photo initiators may include or correspond to photo initiators  122 ,  622 A, or  622 B or second photo initiators  624 , and the light may include or correspond to first light  132  or second light  136 . 
     Method  1100  further includes blending the one or more polymers, the polymerization initiators, and the photo initiators to form a polymer composition, at  1114 . For example, the polymer composition may include or correspond to a dual switchable adhesive, such as DSA  110 , DSA  854 , or DSA  910 . To illustrate, a melt-blend combiner (e.g., an extruder or extrusion system), melt blends the ingredients  120 - 124  together to form a polymer composition that corresponds to DSA. 
     In some implementations, method  1100  further comprises blending one or more additives to form the polymer composition. For example, the additives may include or correspond to additives  126 , such as co-initiators, solvents, or both. Additionally, or alternatively, the method further includes applying, such as by DSA coating system  814 , the polymer composition to a film, such as compound film  150 . 
     Thus, method  1100  describes method of manufacturing a dual switchable adhesive. The dual switchable adhesive (e.g., a three or more phase dual switchable adhesive) enables medical devices to be repositionable and be more resistant to inadvertent contact as compared to conventional switchable adhesives, thereby increasing usability and reducing waste and patient discomfort. Accordingly, the dual switchable adhesives described herein may enable improved wound care and therapy, thereby advancing patient comfort and confidence in the treatment. 
       FIG. 12  illustrates a method  1200  of using a dual switchable adhesive to attach a component to a tissue site. The method  1200  may be performed by a patient or care provider using one or more components of system  100  or system  700 . Method  1200  includes attaching a component to a tissue site via a dual switchable adhesive to form a bond between the component and the tissue site, at  1210 . For example, the component may include or correspond to a compound film  150  or a medical device, such as a component (e.g., drape  732 ) of system  700 . The tissue site may include or correspond to tissue  522  or tissue site  720 , and the dual switchable adhesive may include or correspond to DSA  110 . To illustrate, a patient or care provider applies a component, such as drape  732  or compound film  152 , to tissue  522  or tissue site  720  with DSA  110  or DSA  596  while the DSA is in a first phase  142 . 
     Method  1200  also includes applying moisture to the dual switchable adhesive to increase a bond strength of the bond between the component and the tissue site, at  1212 . For example, the moisture may include or correspond to moisture  134 . To illustrate, a moisture source  114  and/or an applicator  516  provides moisture  134  and/or moisture  534  to the DSA  110 , directly or indirectly, to change from the first phase  142  to the second phase  144 , as illustrated in  FIGS. 1A and 5B , to increase bond strength, as illustrated in  FIG. 4A . As an example, the moisture  134  may be applied to the tissue site, to the DSA or underside/attachment side of the component, the non-DSA or topside of the component, or a combination thereof. 
     Method  1200  includes applying light to the dual switchable adhesive to decrease the bond strength of the bond between the component and the tissue site, at  1214 . For example, the light may include or correspond to first light  132  or second light  136 . To illustrate, a light device  112  or a light source  116  provides first light  132  to the DSA  110  to change from the second phase  144  to the third phase  146 , as illustrated in  FIG. 1A , to decrease bond strength, as illustrated in  FIG. 4A . 
     Method  1200  further includes removing the component from the tissue site, at  1216 . For example, a patient care provider or patient removes the compound film or medical device, such as a bandage, wound closure device, wound dressing, etc., from the tissue  522  or tissue site  720 . In a particular implementation, the medical device is removed after a period of time or after an indication is produced by the DSA, such as a color change, as described with reference to  FIG. 1 . 
     Thus, method  1200  describes a method of using a dual switchable adhesive to attach a component to a tissue site. The dual switchable adhesive enables medical devices to be repositionable and be more resistant to inadvertent contact as compared to conventional light switchable adhesives, thereby increasing usability and reducing waste and patient discomfort. Accordingly, the dual switchable adhesives described herein may enable improved wound care and therapy, thereby advancing patient comfort and confidence in the treatment. 
       FIG. 13  illustrates a method  1300  of using a dual switchable adhesive. The method  1300  may be performed at or by DSA  110 , system  100  (e.g., DSA  110  thereof), system  700  (e.g., DSA  110  thereof), DSA  596 , DSA  854 , or DSA  910 . Method  1300  includes receiving moisture, at  1310 . For example, the moisture may include or correspond to moisture  134 . To illustrate, a DSA receives moisture  134  from a moisture source  114 , a moisture applicator  516 , moisture applicator  719 , wipe  924 , or a combination thereof, as illustrated in  FIG. 1A . 
     Method  1300  also includes transitioning from a first state to a second state, at  1312 . For example, the first state may include or correspond to first phase  142 , and the second state may include or correspond to second phase  144 . To illustrate, the DSA transitions from the first phase  142  to the second phase  144  and increases in cross-linking and increases in peel strength as illustrated in  FIGS. 2C and 3 . 
     Method  1300  includes receiving light, at  1314 . For example, the light may include or correspond to first light  132  or second light  136 . To illustrate, the DSA receives first light  132  from a light device  112  or a light source  116 , as illustrated in  FIG. 1A . 
     Method  1300  further includes transitioning from the second state to a third state, at  1316 . For example, the third state may include or correspond to the third state or phase  146 , such as DSA  110  in  FIG. 2D  or DSA at t 3  or t 4  in  FIG. 4A . To illustrate, the DSA transitions from the second phase  144  to the third phase  146  and increases in cross-linking and decreases in peel strength as illustrated in  FIGS. 2D and 4A . 
     In some implementations, method  1300  further comprises transitioning from the third state to a fourth state. For example, the fourth state may include or correspond to the third state or phase or a fourth state for phase, such as DSA  110  in  FIG. 2D  or DSA at t 3  or t 4  in  FIG. 3 . To illustrate, the DSA increases in cross-linking and decreases in peel strength further as illustrated in  FIG. 4A . 
     In some implementations, method  1300  further comprises providing a visual indication responsive to receiving moisture and/or light. Additionally, or alternatively, method  1300  further comprises providing a visual indication responsive to transitioning between two phases. For example, the first photo initiator may indicate a color change from blue/green to translucent, white to purple, blue to purple, etc., after the moisture has transitioned the DSA from the first phase to the second phase. As another example, the DSA may fluoresce blue when second light is being applied and may provide a yellow color shift (e.g., turn yellow in color) after the second light has transitioned the DSA from the second phase to the third phase. 
     Thus, method  1300  describes method of forming a compound film that includes dual switchable adhesive and that is suitable for use with dual switchable adhesive. The three or more phase dual switchable adhesive enables medical devices to be repositionable and be more resistant to inadvertent contact as compared to conventional switchable adhesives, thereby increasing usability and reducing waste and patient discomfort. Accordingly, the dual switchable adhesives described herein may enable improved wound care and therapy, thereby advancing patient comfort and confidence in the treatment. 
       FIG. 14  illustrates a method  1400  of using moisture and a light device to activate a dual switchable adhesive. The method  1400  may be performed at or by system  100  (e.g., light device  112  and/or light source  116  thereof), light source  718 , or light device  922 . 
     Method  1400  includes applying moisture configured to cause a dual switchable adhesive to transition from a first state to a second state, at  1410 . For example, the moisture may include or correspond to moisture  134  or moisture  534 , and the dual switchable adhesive may include or correspond to DSA  110  or DSA  854 . For example, the first state may include or correspond to the first phase  142 , and the second state may include or correspond to the second phase  144 . To illustrate, a moisture source  114  and/or a moisture applicator  516  provides moisture  134  and/or moisture  534  to DSA  110  to transition the DSA from the first phase  142  to the second phase  144 , as illustrated in  FIG. 1A . 
     Method  1400  optionally includes emitting reference light to determine a distance to a surface, at  1412 . For example, the reference light may include or correspond to light emitted by the reference light source  936 . To illustrate, the reference light source  936  emits reference light which is analyzed by controller  942 . The controller  942  determines a distance between the light device  922  and the surface (e.g., a surface of a component including DSA) based on the reference light and outputs a visual, audio, or haptic indication via indicator  944 . As an illustrative example, the distance is about 20 mm. In other implementations, the distance is between 5 mm to 100 cm. 
     Method  1400  further includes emitting light configured to cause the dual switchable adhesive to transition from the second state to a third state, at  1414 . For example, the light may include or correspond to first light  132  or second light  136 , and the third state may include or correspond to third phase  146 . To illustrate, a light device  112  or a light source  116  provides light  132  to DSA  110  to transition the DSA  110  from the second phase  144  to the third phase  146 , as illustrated in  FIG. 1A . In some implementations, method  1400  further comprises coupling a cover film to the dual switchable adhesive. For example, the cover film  198 ,  498  may by removably coupled to the DSA  110 . 
     Thus, method  1400  describes method of activating a three or more phase dual switchable adhesive. The three or more phase dual switchable adhesive enables medical devices to be repositionable and be more resistant to inadvertent contact as compared to conventional switchable adhesives, thereby increasing usability and reducing waste and patient discomfort. Accordingly, the dual switchable adhesives described herein may enable improved wound care and therapy, thereby advancing patient comfort and confidence in the treatment. 
       FIG. 15  illustrates a method  1500  of packaging a drape, such as a drape including a dual switchable adhesive. The method  1500  may be performed at or by packaging system  816  (e.g., packing equipment  842  and/or sterilization equipment  844  thereof). 
     Method  1500  includes inserting a drape into a pouch, at  1510 . For example, the drape may include or correspond to compound film  152  or drape  732 , and the pouch may include or correspond to pouch  914  or pouch  1002 . To illustrate, packing equipment  842  places one or more drapes in the pouch, as illustrated in  FIG. 8 . 
     Method  1500  also include sealing the drape within the pouch, at  1512 . For example, the drape may be sealed within the pouch by applying heat to the pouch to seal two ends or films of the pouch. To illustrate, packing equipment  842  applies heat to the pouch to seal the drape in the pouch, as illustrated in  FIG. 8 . 
     Method  1500  further includes applying a sterilizing agent to the pouch to sterilize the drape in the pouch, at  1514 . For example, the sterilizing agent may include or correspond “dry processed” or gaseous ethylene oxide. To illustrate, sterilization equipment  844  applies gaseous ethylene oxide to the pouch, as illustrated in  FIG. 1A . In some implementations, the pouch is in a sealed chamber which is evacuated prior to application (e.g., pumping in) of gaseous ethylene oxide. Alternatively, the sterilization equipment  844  evacuates the pouch of air via the one or more filters and pumps in gaseous ethylene oxide to the pouch via the one or more valves. 
     Thus, method  1500  describes method of packaging a drape, such as a drape including a dual switchable adhesive. The method of packaging enables drapes which include moisture cure adhesives to be packaged and sterilized without activation. Additionally, the method of packaging enables the drapes to be stored without activation. 
     It is noted that one or more operations described with reference to one of the methods of  FIGS. 11-15  may be combined with one or more operations of another of  FIGS. 11-15 . For example, one or more operations of method  1100  may be combined with one or more operations of method  1200 . Additionally, or alternatively, one or more operations described above with reference to  FIGS. 1A, 1B, 2A-2D, 3A-3D, 4A, 4B, 5A-5D, 6, 7A, 7B, 8, 9, and 10  may be combined with one or more operations of  FIGS. 11-15 , or a combination of  FIGS. 11-15 . 
     The above specification and examples provide a complete description of the structure and use of illustrative examples. Although certain aspects have been described above with a certain degree of particularity, or with reference to one or more individual examples, those skilled in the art could make numerous alterations to aspects of the present disclosure without departing from the scope of the present disclosure. As such, the various illustrative examples of the methods and systems are not intended to be limited to the particular forms disclosed. Rather, they include all modifications and alternatives falling within the scope of the claims, and implementations other than the ones shown may include some or all of the features of the depicted examples. For example, elements may be omitted or combined as a unitary structure, connections may be substituted, or both. Further, where appropriate, aspects of any of the examples described above may be combined with aspects of any of the other examples described to form further examples having comparable or different properties and/or functions, and addressing the same or different problems. Similarly, it will be understood that the benefits and advantages described above may relate to one example or may relate to several examples. Accordingly, no single implementation described herein should be construed as limiting and implementations of the disclosure may be suitably combined without departing from the teachings of the disclosure. 
     The previous description of the disclosed implementations is provided to enable a person skilled in the art to make or use the disclosed implementations. Various modifications to these implementations will be readily apparent to those skilled in the art, and the principles defined herein may be applied to other implementations without departing from the scope of the disclosure. Thus, the present disclosure is not intended to be limited to the implementations shown herein but is to be accorded the widest scope possible consistent with the principles and novel features as defined by the following claims. The claims are not intended to include, and should not be interpreted to include, means-plus- or step-plus-function limitations, unless such a limitation is explicitly recited in a given claim using the phrase(s) “means for” or “step for,” respectively.