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

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.

To investigate the incidence, characteristics, and clinical risk factors of MARSIs in neonates admitted to the NICU.

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.

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).

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.