Department of Nursing, Asan Medical Center, Seoul 05505, Korea.
College of Nursing, Hanyang University, Seoul 04763, Korea.
Int J Environ Res Public Health. 2021 Aug 30;18(17):9150. doi: 10.3390/ijerph18179150.
The aim of this cross-sectional study was to determine the incidence, types, and factors associated with medical adhesive-related skin injuries (MARSIs) among spinal surgery patients. Adult patients who underwent planned spinal surgery under general anesthesia at a tertiary hospital in Seoul, Korea were enrolled. Data were collected from March through April 2019. Skins under surgical wound dressings were evaluated for MARSI once every morning until discharge. Skin injuries lasting for 30 min or more were considered as MARSIs. Logistic regression was performed to identify factors associated with MARSI. The incidence of MARSIs in surgical areas was 36.4% and the rate per 100 medical adhesives was 9.8%. All MARSIs occurred on postoperative day 1 or 2. A history of contact dermatitis (OR = 10.517, 95% CI = 3.540-31.241, < 0.001) and late ambulation (OR = 1.053, 95% CI = 1.012-1.095, = 0.010) were identified as risk factors for MARSI. Spinal surgery patients were at high risk of MARSIs associated with surgical wound dressings. Patients with a history of contact dermatitis or prolonged bed rest periods need more active skin assessment and more careful skin care to prevent MARSIs after spinal surgery.
本横断面研究旨在确定在接受全身麻醉下进行脊柱手术的患者中,与医用黏胶相关皮肤损伤(MARSIs)相关的发生率、类型和因素。研究纳入了韩国首尔一家三级医院接受计划行脊柱手术的成年患者。数据于 2019 年 3 月至 4 月期间收集。在患者接受手术治疗直至出院期间,每天清晨对手术部位创口敷料下的皮肤进行 MARSIs 评估。皮肤损伤持续 30 分钟或以上则被视为 MARSIs。采用逻辑回归分析来确定与 MARSI 相关的因素。手术部位 MARSIs 的发生率为 36.4%,每 100 个医用黏胶的发生率为 9.8%。所有 MARSIs 均发生在术后第 1 天或第 2 天。接触性皮炎史(OR = 10.517,95%CI = 3.540-31.241, < 0.001)和术后延迟活动(OR = 1.053,95%CI = 1.012-1.095, = 0.010)被确定为 MARSI 的危险因素。脊柱手术患者发生与手术创口敷料相关的 MARSIs 风险较高。有接触性皮炎史或长时间卧床的患者在脊柱手术后需要更积极的皮肤评估和更仔细的皮肤护理,以预防 MARSIs。