Prevention of medical adhesive-related skin injury during patient care: A scoping review

Clinical performance characteristics for bordered foam dressings in the treatment of complex wounds: An international wound dressing technology expert panel review

“…It is important to note that the technique used by the clinician to remove the dressing also plays a role in whether the skin near the wound can be damaged. In recent advice for the prevention of MARSI, clinicians are urged to slowly remove the dressing at a low angle to the skin to reduce the potential for skin stripping during dressing removal which is associated with the viscoelastic response of skin – that stiffness more when it is pulled rapidly 11,18‐20 …”

Mechanical and contact characteristics of foam materials within wound dressings: Theoretical and practical considerations in treatment

“…70 In the more recent literature, this is referred to as medical adhesive-related skin injury (MARSI), which is associated with a history of contact dermatitis or prolonged bed rest periods and is considered preventable, including through the selection of appropriate dressing products, in addition to suitable procedures for application, monitoring, reapplication and removal of the dressings. [72][73][74][75] Despite that foam materials are generally considered non-adhesive, there are many foam-based dressings with an adhesive skin contact layer that enable the dressings to be secured in place without the need for secondary support or fixation. An overly aggressive adhesiveness to the wound or to the fragile peri-wound skin may result in trauma and pain upon removal, and may also cause stripping of the stratum corneum, leading to an inflammatory response and compromised barrier function.…”

“…With the introduction of silicone adhesives, the extent of this problem decreased‡, 69,71 yet peri‐wound skin trauma caused by the repetitive removals of adhesive dressings still occurs and is known to increase the size of wounds and the risk of infections and delays healing, and thereby, adversely affect the quality of life of patients and have cost implications for health care providers 70 . In the more recent literature, this is referred to as medical adhesive‐related skin injury (MARSI), which is associated with a history of contact dermatitis or prolonged bed rest periods and is considered preventable, including through the selection of appropriate dressing products, in addition to suitable procedures for application, monitoring, reapplication and removal of the dressings 72‐75 …”

“…70 In the more recent literature, this is referred to as medical adhesive‐related skin injury (MARSI), which is associated with a history of contact dermatitis or prolonged bed rest periods and is considered preventable, including through the selection of appropriate dressing products, in addition to suitable procedures for application, monitoring, reapplication and removal of the dressings. 72 , 73 , 74 , 75 …”