Xia Qi, Chen Xin, Ma QingHua, Zhang DingDing
Department of PICC, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
Department of Respiratory and Critical Illness, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
J Tissue Viability. 2025 May;34(2):100875. doi: 10.1016/j.jtv.2025.100875. Epub 2025 Feb 25.
Skin exposed to the adhesives to protect catheters is prone to Medical Adhesive-Related Skin Injuries (MARSI). Occurrence of these injuries and the risk factors have not been estimated previously in outpatients with peripherally inserted central catheters. The primary aim of this study was to delineate the characteristics of MARSI and quantify 3 types of incidence rates of MARSI among outpatients with PICC placements.
The study sample included 299 outpatients with PICC placements from October to December 2020. The data were collected at the Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital in Chengdu, China.A three-month cross-sectional survey was conducted at the PICC center of a tertiary general hospital in Western China to analyze the occurrence of MARSI at the catheterization site and related factors. Professional nurses observed and assessed skin conditions during catheter maintenance and collected patient data that could be associated with MARSI occurrence. The relationship between independent variables and MARSI was statistically analyzed using multivariate analysis.
Among outpatients with peripherally inserted central catheters,the incidence rate of MARSI was 14.7 %. Statistical analysis revealed that maintenance personnel (χ = 8.683, P = 0.003), MARSI history (χ = 4.332, P = 0.037), external fixation devices (χ = 4.227, P = 0.04) were significantly associated with the occurrence of MARSI. Moreover, patients over the age of 50 (χ = 4.183, P = 0.041) and the use of transparent dressing (χ = 6.782, P = 0.009) were found to be associated with tension injuries. A multivariate analysis showed that the use of external fixation devices (OR, 2.987; 95 % CI, 1.044 to 8.547; P = 0.041) was an independent risk factor for MARSI.
Patients with PICC in the outpatient department are at a high risk of developing MARSI. To prevent and control MARSI,it is essential to enhance the professional skills of maintenance staff and to pay special attention to patients with a history of MARSI and those over the age of 50. Additionally,the use of external fixation devices and transparent dressings should also be considered.
暴露于用于保护导管的胶粘剂的皮肤容易发生与医用胶粘剂相关的皮肤损伤（MARSI）。此前尚未对接受外周静脉穿刺中心静脉置管的门诊患者中这些损伤的发生情况及其危险因素进行评估。本研究的主要目的是描述MARSI的特征，并量化接受PICC置管的门诊患者中3种类型的MARSI发病率。
研究样本包括2020年10月至12月的299例接受PICC置管的门诊患者。数据收集于中国成都的四川省医学科学院&四川省人民医院。在中国西部一家三级综合医院的PICC中心进行了为期三个月的横断面调查，以分析置管部位MARSI的发生情况及相关因素。专业护士在导管维护期间观察并评估皮肤状况，并收集可能与MARSI发生相关的患者数据。使用多变量分析对自变量与MARSI之间的关系进行统计学分析。
在外周静脉穿刺中心静脉置管的门诊患者中，MARSI的发病率为14.7%。统计学分析显示，维护人员（χ² = 8.683，P = 0.003）、MARSI病史（χ² = 4.332，P = 0.037）、外部固定装置（χ² = 4.227，P = 0.04）与MARSI的发生显著相关。此外，发现50岁以上的患者（χ² = 4.183，P = 0.041）以及使用透明敷料（χ² = 6.782，P = 0.009）与张力性损伤有关。多变量分析显示，使用外部固定装置（OR，2.987；95%CI，1.044至8.547；P = 0.041）是MARSI的独立危险因素。
门诊接受PICC置管的患者发生MARSI的风险较高。为预防和控制MARSI，提高维护人员的专业技能并特别关注有MARSI病史的患者和50岁以上的患者至关重要。此外，还应考虑外部固定装置和透明敷料的使用。
