Medical Adhesive-Related Skin Injuries in Patients in the Neonatal Intensive Care Unit

BACKGROUND: Neonates in the neonatal intensive care unit (NICU) frequently require medical adhesives for device fixation; yet, their immature skin makes them vulnerable to medical adhesive-related skin injuries (MARSIs). Research on the incidence of MARSI and clinical risk factors in this population remains limited. PURPOSE: To investigate the incidence, characteristics, and clinical risk factors of MARSIs in neonates admitted to the NICU. METHODS: A prospective observational study was conducted in a university hospital NICU, including 129 admitted neonates. The overall skin condition was evaluated using the neonatal skin condition scale, whereas the severity of MARSI was assessed using the Three-Item Severity score. The incidence, severity, and common sites of skin injuries were also investigated, and a logistic regression analysis was performed to identify the risk factors for such injuries. RESULTS: MARSIs occurred in 51.9% of neonates. The most affected site was the head and face region (60.3%), and gastric and endotracheal tube fixations were the leading causes. Among all cases, 18.1%, 75%, and 6.9% were mild, moderate, and severe, respectively. Total parenteral nutrition (TPN) was identified as an independent risk factor for MARSI (OR = 4.279; P = .020). IMPLICATIONS FOR CLINICAL PRACTICE: The most common causes of MARSI were gastric and endotracheal tube fixation, and the use of TPN was identified as a significant risk factor. Nursing strategies to reduce MARSIs should be prioritized in infants receiving TPN and requiring fixation in the head and face areas.