Medical adhesive products are a critical tool in healthcare. Across virtually every medical specialty, the use of adhesives facilitates better securement of dressings and medical devices. Proper device securement is particularly important in vascular access, where the overarching goal is to provide reliable vascular access that will last until the end of need.
But when it comes to medical adhesives, can there be too much of a good thing? Medical adhesive-related skin injury (MARSI), including skin tears and epidermal stripping, is an under-recognized yet serious healthcare-acquired condition that affects patients of all ages, particularly the elderly, obese, diabetic, and anyone with sensitive or fragile skin.
Given that MARSI is associated with longer hospital stays, increased costs and reduced patient satisfaction, addressing this largely avoidable complication should be a priority for any healthcare institution.
In the U.S., approximately 1.5 million skin tears occur each year.1 In fact, current evidence suggests that skin tears occur more often than pressure injuries.
A prospective study of 380 patients published in 2020 reported a skin tear prevalence of 20.8% and an incidence of 18.9% within four weeks.2 In a single center pilot randomized controlled trial (n=124 patients), 29% of patients with vascular access devices (VADs) experienced skin complications, including skin tears, blisters, rash, itching and bruising.3
The most obvious consequence of MARSI is skin irritation and discomfort for patients, which can negatively impact patient satisfaction. However, there are many other serious risks that are often overlooked, including MARSI-related infections. Studies show the use of medical adhesives carries a risk of bacterial colonization.4 Moreover, inadequate removal of the adhesive can leave a residue that further increases the risk of bacterial colonization around the catheter site.
In addition, the costs to treat these skin injuries can be significant. One study showed that the cost to treat a skin tear from incidence to complete resolution (approximately 2 weeks) is approximately $21.96 per week.5 Another study found the total cost of tape-induced injury to be $89.67.6 When multiplied by the 1.5 million skin tears that occur annually in the U.S., it’s clear these types of injuries present an enormous economic burden.
While increasingly prevalent, MARSI is also almost entirely preventable. Focusing on prevention could reduce complications, improve clinical outcomes, and raise levels of patient satisfaction.
Healthcare organizations should have MARSI prevention protocols in place to ensure consistent and appropriate care. Such protocols should include:
- Early recognition of patients at high risk of skin injury
- Avoiding excessive tape or dressing changes
- Using proper application and removal techniques
An important component of any removal technique is the use of adhesive remover, which can aid in the removal of dressings, tapes, and most sticky residue from the skin and other surfaces. In fact, the use of adhesive removers to protect skin from injury during dressing removal is supported by the 2021 Infusion Therapy Standards of Practice7, as well as a MARSI patient safety consensus panel.8
An effective remover can help reduce the risk of MARSI by gently and effectively removing adhesive without causing skin tears, irritation or discomfort, particularly for fragile or sensitive skin. It can also help prevent the spread of infection by getting rid of residue that might harbor bacteria and other microorganisms.
Detachol® is a nonirritating adhesive remover that helps break down the adhesive bond between the tape/dressing and skin, is gentle on the patient’s skin, and allows for easy removal of adhesive products and residual material. Unlike conventional adhesive removers, Detachol does not contain alcohol or acetone which can disrupt the skin barrier and cause irritation/injury at the application site.
MARSI is a preventable issue that can be avoided. Prevention requires a comprehensive approach that includes awareness, education, proper technique and an effective adhesive remover like Detachol. By implementing these measures, providers can significantly reduce the incidence of MARSI and improve the quality of care.
Eloquest Healthcare is committed to providing solutions that can help you reduce the risk of conditions like MARSI. For more information about Detachol® Adhesive Remover or to request an evaluation, please contact your sales consultant or Eloquest Healthcare, Inc. by calling 877‐433‐7626 or by completing this form.
- Groom M, Shannon RJ, Chakravarthy D, Fleck CA. An evaluation of costs and effects of a nutrient‐based skin care program as a component of prevention of skin tears in an extended convalescent center. J Wound Ostomy Continence Nurs. 2010; 37: 46‐ doi: 10.1097/WON.0b013e3181c68c89. Erratum in: J Wound Ostomy Continence Nurs. 2010 Mar‐Apr; 37(2): 128.
- LeBlanc K, Woo KY, VanDenKerkhof E, Woodbury MG. Skin tear prevalence and incidence in the long-term care population: a prospective study. J Wound Care. 2020 Jul 1;29(Sup7):S16-S22. doi: 10.12968/jowc.2020.29.Sup7.S16. PMID: 32654616
- Chan RJ, Northfield S, Larsen E, et al. Central venous Access device SeCurement And Dressing Effectiveness for peripherally inserted central catheters in adult acute hospital patients (CASCADE): a pilot randomised controlled trial. Trials. 2017;18(1):458. Published 2017 Oct 4. doi:10.1186/s13063-017-2207-x
- Berkowitz DM, Lee WS, Pazin GJ, Yee RB, Ho M. Appl Microbiol. 1974;28(4):651-654.
- Groom M, Shannon RJ, Chakravarthy D, Fleck CA. An evaluation of costs and effects of a nutrient-based skin care program as a component of prevention of skin tears in an extended convalescent center [published correction appears in J Wound Ostomy Continence Nurs. 2010 Mar-Apr;37(2):128]. J Wound Ostomy Continence Nurs. 2010;37(1):46-51. doi:10.1097/WON.0b013e3181c68c89
- Maene, B. (2013). Hidden costs of medical tape-induced skin injuries. Wounds UK. 9. 46-50.
- Infusion Therapy Standards of Practice: Catheter Associated Skin Injury. J Infus Nurs. 2021;44:S168-S170.
- 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.