Research Article
“Medical Adhesive Related Skin Injury” (MARSI), After Removal of Epidural Catheter Dressing”: Retrospective Audit
1Pain Management Nurse, HMC, Al Wakra Hospital, Qatar
2Arab board in Anesthesia and ICU Specialist Anesthesiologist in Wakra General Hospital, Qatar
3CCT Consultant Anesthesiologist and Pain Management in Wakra General Hospital, Qatar
4Pain Management, HMC, Al Wakra Hospital, Qatar
5Pain Management, HMC, Al Wakra Hospital, Qatar
Received Date: December 15, 2022; Published Date: January 04, 2023
Abstract
Background: It’s well known that after any surgical procedure, wound dressing, fixing epidural catheter, tubes or drains to the skin may lead to skin damage that may occur when medical adhesives are not selected, applied and/or removed properly. In mild cases, there may not be any visible trauma. But in other cases, the injury can be more serious, requiring additional treatment. This can be presented as blisters, skin sluffing, and rash which is called Medical Adhesive Related Skin Injury (MARSI).
MARSI is therefore could be a reason for postoperative morbidity, increase patient discomfort and sometime prolong hospital stay.
The purpose of this retrospective audit is to identify the possible causes of MARSI following removal of epidural dressing in Al Wakra Hospital and offers solutions that could help reducing the incident of MARSI.
Methods: The 67 patients have been reviewed in this audit. All patients were under pain management team care for epidural analgesia follow up after surgery.
This audit conducted in Al Wakra Hospital from Jan 2021 till end of August 2022 after acquiring Hamad Medical Corporation Research Ethical Committee approval, Pain team gathered data collected retrospectively from two sources: the patients file and pain management follow up record. The data were imported into a database (Microsoft Excel) and analysed by pain team staff.
Result: The MARSI developed in 18 patients of the 67 patients included in the audit. The result shown that there were two types of skin injury occurred: Tension injury / blister in 10 cases (56%) and Skin Stripping in eight cases (44%). Lumber region, neck and shoulder were the most common affected area among patients, they were (33%), (22%) respectively.
Conclusion: This audit suggests that MARSI occurs due to the material of dressing itself, component of adhesive material and mechanical stretching in addition to the condition of underlying skin.
