Hu Minhua, Hu Jiajia, Sun Peng, Zheng Hongyan, Zhang Mingyang
The First Department of Surgical Anesthesiology, Zhongshan People's Hospital, Zhongshan, Guangdong, 528403, People's Republic of China.
J Multidiscip Healthc. 2025 Sep 6;18:5563-5580. doi: 10.2147/JMDH.S529677. eCollection 2025.
The aim of this study was to summarize the best evidence for the prevention and management of medical adhesive-related skin injury and to provide a scientific basis for the facial skin care of healthcare professionals and patients undergoing tracheal intubation.
Following the "6S" pyramid model, the literature on the prevention and management of adhesive-associated skin lesions was searched from top to bottom of the guideline website, relevant professional association websites, and Chinese and English databases. The time frame of the search was from the creation of the repository to August 10, 2024. Evidence consolidation was completed in September 2024. The quality of the included studies was assessed, and key evidence was extracted and summarized.
One guideline, five expert consensus reports, three evidence summaries, one cohort study, and two randomized controlled trials were included. Finally, 30 key evidence items were extracted from 7 areas: risk factor identification, skin assessment, selection and use of medical adhesives, skin care, use of skin protection products and removers, pain management, and education and training. The evidence base is characterized by a high proportion of expert consensus (Level 5, 20%) and case-series evidence (Level 4, 60%), reflecting the current lack of robust RCTs in MARSI prevention for intubated patients. However, 73.3% of recommendations carry Grade A strength, supported by either consistent expert consensus or at least one high-quality RCT, providing a solid foundation for clinical implementation. Future research should prioritize large-scale RCTs to validate interventions in diverse populations.
The best evidence for the prevention and management of medical adhesive-associated skin breakdown summarized in this study can be used as a scientific reference for practical nursing care and provide direction for healthcare teams as well as for the care of the facial skin of patients undergoing endotracheal intubation.
本研究旨在总结预防和处理医用胶粘剂相关皮肤损伤的最佳证据，为医护人员及气管插管患者的面部皮肤护理提供科学依据。
遵循“6S”金字塔模型，从指南网站、相关专业协会网站以及中英文数据库的顶部到底部，检索关于胶粘剂相关皮肤损伤预防和处理的文献。检索时间范围为数据库创建至2024年8月10日。证据整合于2024年9月完成。对纳入研究的质量进行评估，并提取和总结关键证据。
纳入1项指南、5份专家共识报告、3份证据总结、1项队列研究和2项随机对照试验。最后，从7个领域提取了30项关键证据：危险因素识别、皮肤评估、医用胶粘剂的选择和使用、皮肤护理、皮肤保护产品和去除剂的使用、疼痛管理以及教育培训。证据基础的特点是专家共识比例较高（5级，20%）和病例系列证据比例较高（4级，60%），这反映出目前在预防气管插管患者医用胶粘剂相关皮肤损伤方面缺乏有力的随机对照试验。然而，73.3%的推荐具有A级强度，得到了一致的专家共识或至少一项高质量随机对照试验的支持，为临床实施提供了坚实基础。未来研究应优先开展大规模随机对照试验，以验证在不同人群中的干预措施。
本研究总结的预防和处理医用胶粘剂相关皮肤破损的最佳证据可作为实际护理的科学参考，为医护团队以及气管插管患者的面部皮肤护理提供指导。
