Wang Dan, Xu Hongzhen, Chen Shuohui, Lou Xiaofang, Tan Jiafei, Xu Ying
At the Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China, Dan Wang, BS, is a master's degree candidate; Hongzhen Xu, BS, is associate director of the nursing department; Shuohui Chen, BS, is director of the nursing department; Xiaofang Lou, BS, is nursing education manager; Jiafei Tan, BS, RN, is a registered nurse; and Ying Xu, BS, RN, is a registered nurse.
Adv Skin Wound Care. 2019 Apr;32(4):176-182. doi: 10.1097/01.ASW.0000553601.05196.fb.
To investigate the prevalence of medical adhesive-related skin injuries (MARSIs) and associated risk factors in a pediatric ICU (PICU).
A cross-sectional design was adopted in the PICU of a university-based children's hospital in eastern China. A total of 232 patients were enrolled, and 611 person-days were analyzed.
Researchers assessed all patients daily for 2 weeks. The use of adhesives and prevalence of MARSIs were recorded. The patients' clinical data were also collected. The prevalence of MARSIs was calculated daily, and the risk factors were examined statistically.
The MARSI prevalence ranged from 23.53% to 54.17% (mean, 37.15%). Multivariate analysis identified being female, age 2 years or younger, hospital stays longer than 5 days, infection, edema, and surgery as independent risk factors. Prevalence by product ranged from 19 to 53 per 1,000 product-days with a mean of 34 MARSIs per 1,000 product-days. The major MARSI types were epidermal stripping and skin tear. The face was the most common MARSI site, and tracheal intubation was the most common inciting condition. Implicated products were acrylate tapes with elastic cloth backings.
Researchers concluded that MARSI is common in the PICU. Skin stripping and skin tear were the most common types, and the face was the most vulnerable site for MARSI, typically attributable to the cloth tape used to affix tracheal intubation. Careful attention should be paid to children with identified risk factors (females, age 2 years or younger, longer hospital stays, edema, infection, or surgery).
调查儿科重症监护病房（PICU）中与医用胶粘剂相关的皮肤损伤（MARSIs）的患病率及相关危险因素。
采用横断面设计，对中国东部一所大学附属医院的PICU进行研究。共纳入232例患者，分析611人日的数据。
研究人员对所有患者进行了为期2周的每日评估。记录胶粘剂的使用情况和MARSIs的患病率。同时收集患者的临床资料。每日计算MARSIs的患病率，并对危险因素进行统计学检验。
MARSIs的患病率在23.53%至54.17%之间（平均为37.15%）。多因素分析确定女性、2岁及以下、住院时间超过5天、感染、水肿和手术为独立危险因素。按产品计算的患病率为每1000产品日19至53例，平均每1000产品日34例MARSIs。主要的MARSIs类型为表皮剥脱和皮肤撕裂。面部是最常见的MARSIs部位，气管插管是最常见的诱发情况。涉及的产品是带有弹性布背衬的丙烯酸胶带。
研究人员得出结论，MARSIs在PICU中很常见。皮肤剥脱和皮肤撕裂是最常见的类型，面部是MARSIs最易发生的部位，通常归因于用于固定气管插管的布胶带。对于具有已确定危险因素（女性、2岁及以下、住院时间长、水肿、感染或手术）的儿童应予以密切关注。
