Incidence of medical adhesive-related skin injury: a reduction by changing posture.

IF 1.5 4区医学 Q3 DERMATOLOGY Journal of wound care Pub Date : 2024-07-02 DOI:10.12968/jowc.2022.0075

Shudi Jiang, Lijuan Yin

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Abstract

Objective: Medical adhesive-related skin injuries (MARSI), defined as skin damage associated with the use of medical adhesive products or devices, are a common and under-reported condition that compromises skin integrity. The prevention and management of MARSI that can occur around the needle insertion site of a chest wall implantable port in hospitalised patients with a tumour remain challenging issues. The aim of this study was to explore whether the incidence of MARSI could be reduced by changing the body position during dressing changes.

Method: Participants were recruited between May 2019 and November 2020 in the oncology department of a tertiary hospital. Patients were randomly assigned to Group AB (supine followed by semi-recumbent position) and Group BA (semi-recumbent followed by supine position) with a standard intervening recovery interval of 21-28 days. Assessments for typical MARSI included itching, the combination of erythema and oedema, and blisters in the port area, and were graded according to the level of severity.

Results: The itch intensity was significantly lower in phase B (semi-recumbent) compared to phase A (supine) (2.35±1.985 versus 5.31±1.332, respectively; p<0.01). Similarly, the severity of erythema and oedema was less severe when comparing phase B to phase A: grade 0 (64.9% versus 10.5%, respectively); grade 1 (28.1% versus 19.3%, respectively); grade 2 (3.5% versus 7.0%, respectively); grade 3 (1.8% versus 45.6%, respectively); and grade 4 (1.8% versus 17.5%, respectively) (Z=5.703; p<0.01). Blisters were found far less frequently in phase B than phase A (1.8% versus 56.1%, respectively; p<0.01).

Conclusion: The study provided statistically significant evidence that patients in a semi-recumbent position receiving dressing at a chest wall implantable port had fewer and less severe injection site MARSI than when in a supine position.

Declaration of interest: The authors have no conflicts of interest to declare.

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与医用粘合剂相关的皮肤损伤发生率：改变姿势可降低发生率。

目的：与医用粘合剂相关的皮肤损伤（MARSI）是指与使用医用粘合剂产品或设备相关的皮肤损伤，是一种常见且报告不足的损害皮肤完整性的病症。如何预防和处理肿瘤住院患者胸壁植入端口针插入部位周围可能发生的 MARSI 仍是一个具有挑战性的问题。本研究旨在探讨是否可以通过改变换药时的体位来降低 MARSI 的发生率：2019年5月至2020年11月期间，在一家三甲医院的肿瘤科招募参与者。患者被随机分配到AB组（先仰卧后半卧位）和BA组（先半卧后仰卧位），标准恢复间隔为21-28天。对典型 MARSI 的评估包括瘙痒、红斑和水肿的结合以及端口区域的水泡，并根据严重程度进行分级：结果：B阶段（半卧位）的瘙痒强度明显低于A阶段（仰卧位）（分别为2.35±1.985和5.31±1.332；P结论：该研究提供了有统计学意义的证据，表明患者的瘙痒强度明显低于A阶段（仰卧位）（分别为2.35±1.985和5.31±1.332）：该研究提供了具有统计学意义的证据，表明与仰卧位相比，半卧位接受胸壁植入端口敷料的患者注射部位MARSI更少、更轻：作者无利益冲突需要声明。

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.