Incidence and risk factors of medical adhesive-related skin injuries in outpatients with peripherally inserted central catheters

Aims: 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. Methods: 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. Results: Among outpatients with peripherally inserted central catheters,the incidence rate of MARSI was 14.7 %. Statistical analysis revealed that maintenance personnel (chi 2 = 8.683, P = 0.003), MARSI history (chi 2 = 4.332, P = 0.037), external fixation devices (chi 2 = 4.227, P = 0.04) were significantly associated with the occurrence of MARSI. Moreover, patients over the age of 50 (chi 2 = 4.183, P = 0.041) and the use of transparent dressing (chi 2 = 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. Conclusions: 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.