School of Nursing, Federal University of Mato Grosso do Sul, Campo Grande, Brazil.
Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirão Preto, Brazil.
Nurs Crit Care. 2024 Mar;29(2):347-356. doi: 10.1111/nicc.12937. Epub 2023 Jun 1.
Critically ill patients are more vulnerable to medical adhesive-related skin injuries (MARSI), whose prevention is a constant challenge and one of the main quality indicators of nursing care. MARSI associated with indwelling urinary catheter (IUC) fixation is a relevant adverse event, mainly because of the constant involuntary traction and high skin vulnerability of the fixation site. Silicone adhesive tape has appreciable qualities for fragile skin among the range of adhesives, leading to the inference that it reduces the risk of MARSI.
To compare silicone adhesive tape for IUC fixation with acrylate tape regarding its safety and efficacy.
This was a randomized controlled trial blinded to the patients and evaluator. Data were collected from an intensive care unit (ICU) of a tertiary university hospital in Brazil. Patients with IUC and no MARSI at the fixation site were considered eligible. The omega (Ω) fixation technique was used for IUC fixation. A total of 132 participants were enrolled and divided into two research groups: 66 patients in the intervention group (silicone tape) and 66 in the control group (acrylate tape). Outcomes were the incidence of MARSI, patient outcome in the ICU and hospital and partial, total and overall spontaneous detachment of the tapes.
The overall incidence of MARSI was 28%, with 21% in the silicone group and 35% in the acrylate group, with no statistically significant difference (p = .121), including the severity of the lesions (p = .902). However, partial (p = .003) and overall (p < .001) detachment of the tapes were more frequent in the silicone group.
Silicone tape is no safer than acrylate tape for IUC fixation and is less adhesively effective.
There is no evidence to support the extensive use of silicone tape in this context.
危重症患者更容易发生与医用黏胶相关的皮肤损伤（MARSI），预防 MARSI 是护理工作的一项持续挑战，也是主要的护理质量指标之一。MARSI 与留置导尿管（IUC）固定有关，是一种相关的不良事件，主要是因为固定部位的皮肤不断受到不自主的牵拉，且皮肤脆弱。在各种黏胶中，硅酮黏胶胶带对脆弱皮肤具有显著的优点，这导致人们推断它可以降低 MARSI 的风险。
比较 IUC 固定用硅酮胶带与丙烯酸酯胶带的安全性和有效性。
这是一项针对巴西一家三级大学医院重症监护病房（ICU）患者的随机对照、双盲临床试验。纳入的患者需符合以下条件：留置 IUC 且固定部位无 MARSI。采用 omega（Ω）固定技术固定 IUC。共纳入 132 名参与者，分为两组：66 名干预组（硅酮胶带）和 66 名对照组（丙烯酸酯胶带）。研究结果为 MARSI 的发生率、患者在 ICU 和医院的转归以及胶带的部分、全部和总体自发性脱落。
MARSI 的总发生率为 28%，硅酮组为 21%，丙烯酸酯组为 35%，差异无统计学意义（p = .121），包括损伤严重程度（p = .902）。然而，硅酮组胶带的部分（p = .003）和总体（p < .001）脱落更为频繁。
与丙烯酸酯胶带相比，硅酮胶带用于 IUC 固定时并不更安全，且黏性效果更差。
没有证据支持在这种情况下广泛使用硅酮胶带。
