It is well known that the use of medical adhesives is associated with potential skin damage during a variety of procedural and treatment courses, including vascular access. This skin damage can present as medical adhesive-related skin injury (MARSI). MARSI prevalence was examined in a study undertaken by Farris, et. al, to determine the scope of patients affected by this complication. A patient safety summit was also convened to present clear definitions of both medical adhesive products and MARSI, as well as discuss MARSI prevention strategies when medical adhesive products are utilized in treatment.1,2
Types of Medical Adhesive Products and Frequency of Use
Medical adhesive products include any product used to attach an external device (such as tape, dressing, catheter, electrode, pouch or patch) to skin, or to approximate wound edges. 1,2
The following medical adhesive products were found to be the most frequently used in patients that developed MARSI: 1
- Peripheral intravenous (PIV) dressings
- Surgical dressings
- Surgical closures
- Wound dressings
- Tape
- Electrodes
Additionally, most patients are treated with multiple adhesive devices during their in-patient stays.1 With this practice being a common course of action, it is important to properly apply and remove each device throughout patients’ duration of care.
Medical Adhesive-Related Skin Injury (MARSI): Definition and Rates of Occurrence
MARSI was defined by the patient safety summit as the persistence of erythema and/or other cutaneous abnormalities (vesicle, bulla, erosion, or tear) for at least 30 minutes following adhesive removal.1,2
In a study conducted by Farris, et. al, the daily per subject MARSI prevalence had a mean rate of 13.0%, with an observed range of 3.4% to 25%.1 With this rate of occurrence, MARSI is a clinically relevant complication that negatively impacts patients’ satisfaction and safety.1,2
MARSI: Preventable Causes and Potential Solutions
The table below lists preventable causes of MARSI.2
Allowing both skin and skin prep/barriers to dry before application is important to optimize performance and patient outcome, as not doing so is a common cause of irritant contact dermatitis. Avoiding excessive tape or dressing changes is also key to MARSI prevention. When dressing of tape replacement or removal is necessary, proper technique should always be employed.2 One way to protect skin from injury during such removals is the use of adhesive removers. This strategy is supported by both the 2021 Infusion Therapy Standards of Practice and a MARSI patient safety consensus panel.2,3
MARSI is both clinically relevant and potentially avoidable. Focusing on prevention could reduce complications, improve clinical outcomes, and raise levels of patient satisfaction.1
Eloquest Healthcare offers Detachol® Adhesive Remover, a non‐irritating adhesive remover in an easy‐to‐use sterile applicator. Detachol minimizes risk of discomfort and skin injury associated with removal of dressings, tapes, and sticky residue from the skin.
For more information about Detachol® Adhesive Remover, please contact your sales consultant or Eloquest Healthcare, Inc. by calling 1‐877‐433‐7626 or by completing this form.
References
- Farris M, Petty M, Hamilton J. Medical Adhesive-Related Skin Injury Prevalence Among Adult Care Patients. J Wound Ostomy Continence Nurs. 2015;42(6):589-98.
- McNichol L, Lund C, Rosen T. Gray medical adhesives and patient safety: state of the science. Consensus statements for the assessment, prevention, and treatment of adhesive-related skin injuries. J Wound Ostomy Continence Nurs. 2013;40:365-80.
- Infusion Therapy Standards of Practice: Catheter Associated Skin Injury. J Infus Nurs. 2021;44:S168-S170.