Abstract
To identify and analyze the point prevalence of medical adhesive-related skin injury in patients hospitalized in cardiac Intensive Care Units and demographic and clinical factors associated to their occurrence. Cross-sectional study conducted in Intensive Care Units of two public hospitals, reference centers for cardiology, located in São Paulo city, with 123 patients. Demographic and clinical data from patients' medical records were collected and lesions were identified through skin inspection. The data were analyzed through descriptive statistics and bivariate and multivariate analysis (Classification and Regression Tree). Medical adhesive-related skin injury was presented by 28 patients, which amounts to a 22.7% prevalence. Its main causative agent was transparent polyurethane film (46.9%) and the cervical region was the most affected area (25.1%). From the multivariate analysis, the associated factors were found to be the presence of serum urea higher than or equal to 48.5 mg/dL and platelets lower than 193,500 mm3 or platelets higher than or equal to 193,500 mm3 and systolic blood pressure higher than or equal to 122 mmHg. This study has contributed to knowledge related to the epidemiology of this type of injury, favoring preventive care planning.
Highlights
Skin integrity maintenance is an indicator of nursing care quality
Considering that no studies on the prevalence of Medical adhesive-related skin injury (MARSI) were found in patients hospitalized in cardiologic Intensive Care Units (ICU), this segment is based on the presentation of studies conducted with hospitalized patients in general
An international study conducted in two non-critical care units in Midwestern United States of America found a mean prevalence of 13% (n=1,189), with the most expressive rate in the subpopulation of patients between 65 and 74 years[12]
Summary
Skin integrity maintenance is an indicator of nursing care quality. In health services, medical adhesive-related skin injuries are meaningful, but undervalued, while potentially impacting outcomes and patients’ satisfaction and safety[1].Medical adhesives are commonly used in health services. Skin integrity maintenance is an indicator of nursing care quality. Medical adhesive-related skin injuries are meaningful, but undervalued, while potentially impacting outcomes and patients’ satisfaction and safety[1]. Medical adhesives are commonly used in health services. These include a variety of products, such as tapes, dressings, electrodes, and stoma barriers, among other adhesives used to fix devices on the skin, monitoring patients in a non-invasive manner, performing secondary wound closure, approximating injury borders, and stimulating the process of skin healing. The most used ones include acrylates, silicones, hydrocolloids, latex, and polyurethanes[2]. These must be selected according to their quality and skin type and should be applied and removed properly to avoid skin injury[3]
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