Medical adhesive related skin injury (MARSI) is an often preventable complication associated with various types of adhesive used in wound management and during medical procedures. Identifying the factors that contribute to MARSI can help reduce the problem.

1. Identify High-Risk Patients

Patients of certain demographics or those with certain medical issues make them high-risk for MARSI. When you can identify patients that are already at an elevated risk, you can be more cautious about the adhesives you use and possibly change their wound care schedule, when applicable. Generally, patients at both extremes in terms of age are considered high-risk. Both neonates and geriatric populations have sensitive and/or thin skin that is more susceptible to tearing and irritation. Another high-risk population is patients who are on high doses of steroids or long-term steroid therapy, which can cause thinning of the skin.

2. Use the Appropriate Adhesive

There are many types of medical adhesive, each with unique features that make it applicable for different medical needs. Never use an adhesive that is stronger than necessary. This places patients at an unnecessary risk for skin tears and irritation during removal. Another consideration is using adhesives that are designed with stretch. These are appropriate for use on joints and on injuries where swelling is expected. Since the adhesive moves with the patient, it is less likely to cause skin irritation during wear. Some dressings are made to allow the skin underneath to breathe, which may be appropriate to prevent the skin underneath from staying damp and more prone to irritation or bacteria growth.

3. Take Care with Changing and Removal

Changing dressings regularly is critical for reducing MARSI or identifying problems early. When dressings are changed frequently and any areas where medical adhesive has been applied are checked frequently, it is easier to spot problems before they cause significant skin damage. You should check these areas for any signs of redness or if the patient reports itching, both of which could be a sign of contact dermatitis or the development of blisters. When removing dressings or adhesive, it is important to do so with care. Any adhesive should be removed slowly and you may need to hold the skin in place as you remove adhesive to avoid tears. When necessary, dampening the adhesive so it peels away easier may be an option.

MARSI is a common complication associated with wound therapy and medical treatments. Fortunately, many incidences of MARSI can be reduced or eliminated with proper use of the right adhesive and care both during application and removal.