Medical viscose related skin injury
With the development of medical science, there are more and more kinds of adhesive products used in TCM clinic, and their applications are more and more extensive, such as transparent dressing, wound dressing, electrode patch, acupoint sticking, common medical tape and so on. But related skin damage can also occur. Medical adhesive skin injury is a very common skin problem, which may occur in patients of any department and any age. In clinical work, we often ignore this problem. If the medical glue is improperly selected and the sticking/removing method is incorrect, it will easily lead to skin damage, which may bring pain to patients and increase additional medical expenses. Therefore, it is of great significance to understand the medical adhesive skin injury in clinic.
Medical adhesive skin injury (MARSI) refers to persistent erythema and/or other skin abnormalities (including but not limited to blisters, bullae, erosion or tearing) within 30 minutes or more after removing adhesive products.
Classification of MARSI (3 categories and 7 subclasses)
1
Mechanical injury: skin tearing, skin peeling, tension injury.
Skin tear
Cause of occurrence:
Surface separation caused by shear force, friction force and/or blunt force.
High incidence parts and people:
Osteoid process in the elderly.
condition
Skin exfoliation
Cause of occurrence:
Removing adhesive leads to the separation of epidermal cells, and repeated use and removal leads to the destruction of skin barrier function.
High incidence parts and people:
It often occurs in extreme age, but it can occur in all ages, and the incidence rate in pediatrics is 8- 17%.
Tension damage
break through
Cause of occurrence:
The hard backing is damaged by the movement of skin; A large number of adhesive tapes are fixed and bandaged, and the movement of joint parts, skin friction and tissue edema increase the risk of tension injury.
High incidence parts and people:
The incidence of tension injury after hip/knee surgery is 6-4 1%.
2
Dermatitis: Irritating contact dermatitis and allergic dermatitis.
Irritating contact dermatitis
Cause of occurrence:
Removing adhesive leads to the separation of epidermal cells, and repeated use and removal leads to the destruction of skin barrier function.
High incidence parts and people:
It often occurs in extreme age, but it can occur in all ages, and the incidence rate in pediatrics is 8- 17%.
Allergic dermatitis
Cause of occurrence:
Removing adhesive leads to the separation of epidermal cells, and repeated use and removal leads to the destruction of skin barrier function.
High incidence parts and people:
It often occurs in extreme age, but it can occur in all ages, and the incidence rate in pediatrics is 8- 17%.
three
Others: skin infiltration, folliculitis
Skin infiltration:
Glue under the sealant tape will cause skin penetration and irritation.
Folliculitis:
Improper removal of adhesive tape (too fast and too high angle) will lead to inflammation of hair follicles.
Correct sticking and tearing methods of medical glue
In the application of medical adhesive, it is very important to master the correct sticking and tearing methods. In the sticking technology of medical adhesive, tension-free sticking method and "0" removal method are recommended, which can effectively reduce the occurrence of MARSI. At the same time, ensure that the disinfectant is completely dry before pasting, pay attention to the skin condition, and replace and handle it in time.
Tension-free sticking and low-angle peeling technology are adopted, and the paste should be parallel to the skin incision; Slowly, at a low angle, gently, parallel to the skin and always provide skin support. Before using the dressing, the potential risk factors of the skin around the wound should be evaluated in detail. The dressing should be parallel to the wound and applied to the flexion position of the joint. When removing the dressing, it should also be used parallel to the wound. The operation technique of nursing staff is an important link to prevent the occurrence of MARSI. Sticking with tension should be avoided, and a certain space should be left in the parts that need to be moved, so as to avoid repeatedly uncovering the adhesive tape, uncovering the adhesive tape against the hair direction, holding the skin without hands, and choosing the adhesive tape that is too sticky and allergic.
Changing 0 degrees