Kim MJ, Jang JM, Kim HK, Heo HJ, Jeong IS, et al.
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy an.... Date of publication 2019 Nov 1;volume 46(6):491-496.
1. J Wound Ostomy Continence Nurs. 2019 Nov/Dec;46(6):491-496. doi:
10.1097/WON.0000000000000592.
Medical Adhesives-Related Skin Injury in a Pediatric Intensive Care Unit: A
Single-Center Observational Study.
Kim MJ(1), Jang JM, Kim HK, Heo HJ, Jeong IS.
Author information:
(1)Min Ji Kim, MSN, College of Nursing, Pusan National University, Yangsan,
South Korea. Jeong Mi Jang, BSN, College of Nursing, Pusan National University,
Yangsan, South Korea. Hye Kyung Kim, MSN, College of Nursing, Pusan National
University, Yangsan, South Korea. Hyun Ju Heo, BSN, College of Nursing, Pusan
National University, Yangsan, South Korea. Ihn Sook Jeong, PhD, College of
Nursing, Pusan National University, Yangsan, South Korea.
PURPOSE: The purpose of this study was to identify the purpose, type, and site
of medical adhesives (MAs) used for patient care and to measure the incidence of
medical adhesive-related skin injury (MARSI) among patients in a pediatric
intensive care unit (PICU).
DESIGN: A prospective observational study.
SUBJECTS AND SETTING: The sample comprised 60 children hospitalized at a 13-bed
PICU in a university-affiliated tertiary care hospital in Yangsan (southeastern
Korea) from August 2 to October 25, 2017. The median age was 2.9 months, and the
composition of male and female was 34 (56.7%) and 26 (43.3%), respectively.
METHODS: The skin of all participants was examined by first-line staff nurses
every shift and occurrences of MARSI were confirmed by a wound care specialist.
Characteristics of MA use were analyzed with descriptive statistics, and
incidence rates of MARSI were calculated using 3 methods: (1) rate per 100
patients, (2) rate per 100 MAs, and (3) rate per 1000 days of MA use.
Chi-squared (χ) tests were conducted to analyze associations between MARSI and
sex, age group, and primary service type (medical vs surgical).
RESULTS: The total number of MAs used was 414 and the total day of use of MAs
was 1424.8. Medical adhesives most frequently used were endotracheal tube
fixation devices (55/414) and fixation devices for the face (167/414). The
number of MARSI occurrences was 35 cases in 23 patients; skin stripping was the
most common form of MARSI (26/35). The incidence rate was 58.3 MARSIs per 100
patients, 8.5 MARSIs per 100 MAs, and 24.6 MARSIs per 1000 days of MA use. The
MARSI incidence rate was significantly different based on age group (P = .014).
CONCLUSION: We observed a frequent occurrence of MARSI among patients in the
PICU, especially in patients requiring long-term use of MAs such as central line
dressings or in MAs placed in high-moisture areas such as near an endotracheal
tube. We highlight the importance of regular skin inspection and frequent but
gentle replacement of MAs for prolonged use of MAs in critically ill children.
DOI: 10.1097/WON.0000000000000592
PMID: 31738304 [Indexed for MEDLINE]
