Medical Adhesive-Related Skin Injury

by the WoundSource Editors Best practice in skin care focuses on the prevention of skin breakdown and the treatment of persons with altered skin integrity. When we ask what causes skin damage we should consider the conditions that can harm the skin, including excessive moisture and overhydration, altered pH of the skin, the presence of fecal enzymes and pathogens, and characteristics of incontinence such as the volume and frequency of the output and whether the output is urine, feces, or both. If left untreated or not treated appropriately, moisture-associated skin damage or MASD can lead to further complications such as Candida infections, bacterial overgrowth, pressure injuries, and medical adhesive-related skin injury (MARSI). These can occur individually or overlap, which can make them even more difficult to manage. Today our focus is to discuss each of these complications of MASD in more detail and address some of the most common issues leading to their development.

“Top-down skin injury” is an increasingly common term used to describe superficial cutaneous injury. These injuries result from damage beginning at the skin’s surface or soft tissue. In contrast, “bottom-up” injuries are often the result of ischemia. Top-down injuries are usually caused by mechanical forces, inflammation, or moisture. Medical adhesive-related skin injury (MARSI) is a frequently seen type of top-down skin injury that is almost always preventable. In this blog, I focus on preventing MARSI and describe the different techniques and adhesives (along with adhesive alternatives) available for use.1

By Margaret Heale RN, MSc, CWOCN Wounds are dressed every day, and much goes into the choices that are made to properly apply wound dressings. The condition of the periwound skin should be a major factor in the decisions made, as injuring this area can extend the wound and cause considerable pain. Tape removal is one of the most painful areas of wound care.1

Medical device–related pressure injuries (MDRPIs) are recognized as a significant problem, evidenced by the inclusion in the National Pressure Injury Advisory Panel pressure injury definitions and described by Pitman and Gillespie in 2020.1 Prevention of medical device-related pressure injuries is a goal that may be achieved through meticulous patient care.

Heidi Cross, MSN, RN, FNP-BC, CWON "Me and Jenny goes together like peas and carrots." – Forrest Gump Just like Forrest's peas and carrots, a pressure ulcer lawsuit and a pain and suffering allegation inevitably "goes together." For good reason, because pain is an ever-present problem in patients with pressure ulcers, venous and arterial ulcers, and even diabetic ulcers, despite sensory issues. How do you, as a health care provider, best protect and defend yourself against a pain and suffering allegation?

By Emily Greenstein, APRN, CNP, CWON, FACCWS The New Year is finally here, the beginning of a new decade. And we all know that with the calendar change comes the urge to get rid of any and all bad habits. Time to start over, wipe the slate clean, and transform into something amazing. Except, in reality it never seems to happen that way. We may start out well and then fall off the wagon and back into old habits.

By Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP What does your facility do to raise awareness regarding pressure injury prevention? We have lots of educational opportunities throughout the year, but one of our most important and prepared for days is the third Thursday in November – World Wide Pressure Injury Prevention Day! This is a day to raise awareness that has been promoted by the National Pressure Ulcer Advisory Panel (NPUAP). Every year, the NPUAP puts out a press release and lots of good information in terms of ways to educate and engage staff on such an important topic, on a national level.