Wound Care Made Incredibly Easy

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External threats to skin integrity

Handle with care

Memory jogger

A university hospital in China reported their intensive care unit (ICU) MARSI incidence rate of 11.86% including epidermal stripping and skin tears (Gao et al., 2020). It makes sense since there are many medical devices in the ICU and many patients in the ICU are those with fragile skin. This group noted independent risk factors included moderate-to-severe edema, hyperthermia, and use of medica tions such as immunosuppressants and anticoagulants.

A unique way to think about any superficial break in skin is as if it is a Petri dish in a lab—full of nutrients to grow germs. Imag ine that as soon as the first line of de fense is broken (skin), the bacteria that is always present on the surface sees a neon “OPEN” sign. If this is near a wound or entry point for a device like an intravenous line, it can be a recipe for disaster!

Unfortunately, “tape burns,” as they used to be called, are common and often occur near wounds, surgical incisions, or where medical devices penetrate the body.

Preventing MARSIs

Twice-daily moisturizing of dry skin is helpful, but this is not an option under adhesive devices or dressings. There are some alternative methods to consider.

Method

How it works

Did you know?

The nonalcohol versions prevent stinging of nearby open wounds or previously damaged skin and also tend to be more durable.

Liquid skin barrier application prior to adhesive application

Provides an extra layer of protection of breathable “plastic” film if applied prior to tape or clear film protective dressings; can reduce trauma during removal Staying parallel to skin level reduces the amount of force needed to detach the adhe sive, lessening the chance of MARSI. Anchoring the dressing as you stretch it prevents it from tearing off the skin.

Clear film dressings can be removed by loosen ing opposite edges with adhesive remover or oil then grasping both edges and pulling them apart parallel to the skin. This breaks the adhesive in the center easily.

Remove clear polymer film dressings by stretching the film parallel to the skin, not pulling up away from the skin level. Put pressure on the edge you are pulling away from to prevent it from strip ping skin.

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