Medical adhesive‐related skin injuries in the neonatology department of a teaching hospital

• Published in: Nursing in critical care Vol. 27; no. 4; pp. 583 - 588
• Main Authors: Oliveira Marcatto, Juliana, Santos, André Soares, Oliveira, Ananda Jéssyla Felix, Costa, Anna Caroline Leite, Regne, Giulia Ribeiro Schettino, Trindade, Raquel Elias, Couto, Débora Lara, Souza Noronha, Kenya Valéria Micaela, Andrade, Mônica Viegas
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-07-2022; Wiley Subscription Services, Inc
• Subjects: Adhesives; Critical care; Iatrogenesis; infant; Injuries; Medical dressings; Neonatal care; newborn; Newborn babies; Skin; surgical tape; Teaching hospitals; wounds and injuries; skin; surgical tape; wounds and injuries; newborn; infant
• ISSN: 1362-1017; 1478-5153
• DOI: 10.1111/nicc.12621

Background
Medical adhesives are used to affix components to the skin. They are part of procedures performed by medical specialties because of their participation as constituents of different products, such as tapes, dressings, and electrodes.
Aim
This study aims to assess the prevalence of, and factors associated with, the development of medical adhesive‐related skin injuries (MARSIs) in patients treated with medical tapes in the neonatology department of a large teaching hospital in Brazil.
Study Design
Cohort study.
Methods
All premature newborns (gestational age from 28 to <37 weeks) admitted in the neonatal intensive care unit of a teaching hospital, from March to August 2019, were followed up. Neonate skin condition was assessed based on the Neonatal Skin Condition Scale (NSCS). Data analyses were conducted in R software.
Results
In total, 46 premature newborns were included in the study; 552 evaluations were performed—mean of 11.7 per patient. Most neonates (n = 41; 89.1%) used adhesive tapes, either paper tape (n = 37; 80.4%) or transparent film dressing (n = 34; 73.9%). Newborns' face and head were the most affected body regions (n = 125; 50.2%). Eight patients had MARSIs (19.5% of patients who used tape). NSCS scores (P value <.001) and the adopted warming system (P value = .01302) were associated with the occurrence of MARSIs. Incubators seem to be a protective factor for MARSI (OR = 0.048; IC95% = 0.0008‐0.75; P value = .013).
Conclusion
Adhesive tapes in premature newborns should be considered a risk factor for injuries. Although NSCS showed mild‐to‐moderate impairment and lesion severity was low, this event is relatively frequent in neonatal units.
Relevance to Clinical Practice
Awareness of the risk associated with adhesive tape application and removal in newborns allow health services to better address the problem by enforcing good practices, elaborating better protocols, qualifying the health care professionals, and potentially selecting softer tapes for neonates.