Medical adhesive-related skin injury in cancer patients: A prospective cohort study.
José Ferreira Pires-Júnior, Tânia Couto Machado Chianca, Eline Lima Borges and 2 others
PMID 34755780WHAT IT FOUND
Among adult cancer ICU patients with peripheral venous catheters, 31.0% developed medical adhesive-related skin injury.
Nurses should check skin daily, especially when turgor is decreased, hematoma or edema is present.
Key findings
0131 of 100 patients developed medical adhesive-related skin injury at the peripheral venous catheter insertion site.
02The incidence was 31.0%, and the incidence density was 3.4 cases per 100 people-days.
03Decreased turgor, hematoma and edema were the variables in the final model.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in an intensive care unit at a cancer hospital, and the 100 patients were selected non-probabilistically from 338 screened, so it may not represent other units or patient groups. It did not evaluate the techniques for applying and removing medical adhesives, or the use of the peripheral venous access care protocol, so skin findings and care actions cannot be separated. This was an observational cohort, so it cannot prove that decreased turgor, hematoma or edema caused injury. The paper's text calls decreased turgor, hematoma and edema risk factors, but the supplied table gives hazard ratio values of 0.53, 0.61 and 0.71 for them, so the reported direction is inconsistent. The skin assessment instrument was built by the researchers and only reviewed by two nurses, so measurement of MARSI may not be fully standardised.
The easy way to misread this
Do not conclude that decreased turgor, hematoma or edema cause medical adhesive-related skin injury or that nurses should change adhesive products. This was an observational ICU cohort, and the study did not test adhesive type, application or removal technique.