Incidence of Medical Adhesive-Related Skin Injuries and Associated Factors After Pediatric Congenital Heart Surgery: A Prospective Cohort Study.

Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society 2022 Mar-Apr 01

filter terms:

The aim of this study was to identify the incidence, characteristics, and factors associated with medical adhesive-related skin injuries (MARSI). Prospective cohort study. The sample comprised 136 children in the postoperative period after congenital heart surgery. The study setting was in a 31-bed pediatric surgical intensive care unit (ICU) of a university hospital in Sao Paulo, Brazil. Patients were followed from admission, with daily skin assessments, until the onset of MARSI or ICU discharge. Outcomes were compared by Fisher's exact test, Pearson's χ2 test, Mann-Whitney test, Brunner-Munzel test, and Welch 2-sample t test. The incidence of MARSI was 60.3%, with 85 injuries in 82 patients. The highest occurrence was on postoperative day 2 (27 wounds; 31.8%). The most frequent medical adhesive associated with MARSI was transparent film dressing (n = 74; 86.6%). Factors associated with MARSI were age (P = .000), number of devices inserted (P = .000), Braden Q Scale score (P = .005), duration of surgery (P = .021), cardiopulmonary bypass duration (P = .000), duration of mechanical ventilation (P = .000), and length of ICU stay (P = .000). Children who developed MARSI received more blood components (P = .039), vasopressors (P = .000), and corticosteroids (P = 0.000); required longer sedation (P = .000); and had more edema (P = .001). This high incidence indicates the need for greater awareness and prompt action in response to MARSI. Polyurethane transparent film without concurrent use of a skin barrier product should be avoided. Copyright © 2022 by the Wound, Ostomy and Continence Nurses Society.

Citation

Jeiel Carlos Lamônica Crespo, Daniela Reuter do Amaral, Ticiane Carolina Gonçalves Faustino Campanili, Ligia Cristina Camara Cunha, Fatima Gil Ferreira, Filomena Regina Gomes Gallas, Jurema da Silva Herbas Palomo, Renata Eloah de Lucena Ferretti-Rebustini. Incidence of Medical Adhesive-Related Skin Injuries and Associated Factors After Pediatric Congenital Heart Surgery: A Prospective Cohort Study. Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society. 2022 Mar-Apr 01;49(2):137-142