Incidence and risk factors for medical adhesive-related skin injury in catheters of critically ill patients: A prospective cohort study

Abstract

Aim: To investigate the incidence and risk factors for medical adhesive-related skin injury (MARSI) in catheters of critically ill patients. Methods: A prospective cohort study was conducted in adult intensive care units of two Brazilian university hospitals. A total of 150 patients (439 catheters) were included. Skin exposed to the catheter fixation adhesives (central venous, nasogastric, nasoenteral and indwelling urinary) was examined daily by four trained researchers. The patients sociodemographic and clinical data were collected from their electronic medical records. The association between independent variables and MARSI was investigated by bivariate statistics, followed by multiple logistic regression. Results: The MARSI incidence was 42% (8.64 MARSIs per 100 patients/day). Advanced age, prolonged hospital stay, dry skin, repetitive adhesive removal, low Braden Scale score and hypoalbuminemia were associated with MARSI (p < .05). According to multivariate logistic regression, dry skin increased the chance of MARSI by 5.21 times (odds ratio [OR] 5.21; 95% confidence interval [95% CI] 2.43-11.11), while the Braden Scale score was a protective factor, showing 31% less chance of MARSI for each added score (OR 0.69; 95% CI 0.57-0.85). A higher incidence of MARSI was observed in nasoenteral catheters and in those fixed with adhesive using natural rubber. The MARSI types were predominantly mechanical (70.3%): skin stripping (41.3%), skin tear (26.1%) and tension injury or blister (2.9%). Conclusions: MARSI is a common event in adult intensive care units and most risk factors are modifiable. Preventive actions are potentially capable of reducing incidence, optimizing financial resources and improving clinical results.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study was partly financed (translation from Portuguese to English) the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior - CAPES - Brasil (Finance Code 001) and Federal University of Mato Grosso do Sul.

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I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study was approved by the Research Ethics Committee of the Universidade Federal de Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil (No. 3,096,666) and complied with national and international ethical guidelines for research involving human subjects. Study participants signed the Free Informed Consent Form (FICF) in duplicate, one being delivered to the participant and the other remaining with the researcher.

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Data Availability

All data produced in the present study are available upon reasonable request to the authors

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