While wound dressings and wound closure devices play an important role in postoperative care, serious injuries as a result of the synthetic adhesives found in these products can often cause more harm than good.

虽然伤口敷料和伤口闭合装置在术后护理中起着重要作用，但这些产品中发现的合成粘合剂导致的严重伤害往往弊大于利。

Medical Adhesive Related Skin Injuries (MARSI) affect over 1.5 million patients each year and are a leading cause of painful postoperative complications including delayed wound healing, surgical site infections (SSIs) and poor scarring outcomes.

医用粘合剂相关皮肤损伤（MARSI）每年影响150多万患者，是术后疼痛并发症的主要原因，包括伤口愈合延迟，手术部位感染（SSI）和瘢痕形成不良。

MARSIs are often underreported in medicine, highlighting the critical need for increased awareness and improved preventive measures to address this important patient safety concern.

MARSIs在医学上经常被低估，这突出表明迫切需要提高认识和改进预防措施，以解决这一重要的患者安全问题。

How do medical adhesive related skin injuries (MARSIs) occur?

医用粘合剂相关皮肤损伤（MARSIs）是如何发生的？

MARSIs occur as a result of the improper selection, application or removal of medical adhesives, tapes, or dressings. Skin rashes to medical adhesives can occur up to two weeks after their application and are often underreported by healthcare professionals. The last thing patients should have to worry about after surgery is dealing with additional complications caused by the very products meant to aid their recovery..

由于不正确选择、应用或移除医用粘合剂、胶带或敷料而导致MARSIs发生。医用粘合剂在使用后两周内可能会出现皮疹，医疗保健专业人员通常会漏报。手术后患者最不应该担心的事情是处理由旨在帮助他们康复的产品引起的额外并发症。。

Unfortunately, these complications do not have a standardized method for their prevention, reporting or treatment.  A survey of 918 wound care health professionals in 2016 found that MARSI was not reported in their facility 71% of the time and only 31% of respondents were aware of the term. Educating both clinicians and patients regarding MARSIs and highlighting the importance of wound dressing selection are crucial measures to mitigate these postoperative complications.

不幸的是，这些并发症没有标准化的预防，报告或治疗方法。2016年对918名伤口护理保健专业人员进行的一项调查发现，他们的设施中71%的时间没有报告MARSI，只有31%的受访者知道这个术语。对临床医生和患者进行有关MARSIs的教育，并强调伤口敷料选择的重要性，是减轻这些术后并发症的关键措施。

These complications lead to the disruption of the epidermal barrier which cause delayed wound healing, inflammation, irritation and increase the susceptibility of the wound to outside pathogens which can cause infections..

这些并发症导致表皮屏障的破坏，导致伤口愈合延迟，炎症，刺激，并增加伤口对可引起感染的外部病原体的敏感性。。

Common complications as a result of MARSIs

MARSIs的常见并发症

Adverse events as a result of medical adhesive related skin injuries fall into the following categories:

医用粘合剂相关皮肤损伤导致的不良事件分为以下几类：

Allergic Contact Dermatitis: A skin hypersensitivity reaction to the adhesive or dressing material which causes a rash that may either be localized to the area of exposure or go beyond.

过敏性接触性皮炎：对粘合剂或敷料产生的皮肤超敏反应，可导致皮疹，皮疹可能局限于暴露区域或超出暴露区域。

Irritant Contact Dermatitis: non-allergic contact dermatitis a result of a chemical irritant that occurs in a localized area correlated to the area of exposure.

刺激性接触性皮炎：非过敏性接触性皮炎是化学刺激物的结果，发生在与暴露区域相关的局部区域。

Tension Injury or Blister: Separation of the epidermis from the dermis as a result of shear forces that occur when a medical tape or dressing is applied in an area with tension or movement. Often results in blister formation.

张力损伤或水疱：当医用胶带或敷料应用于张力或运动区域时，由于剪切力而导致表皮与真皮分离。通常会导致起泡。

Skin Tear: Removal of one or multiple layers of the skin as a result of dressing or tape removal.

皮肤撕裂：由于敷料或胶带的去除而去除一层或多层皮肤。

Maceration: Injury as a result of moisture being trapped against the skin for extended periods of time resulting in the softening and disruption of the skin.

浸透：由于水分长时间滞留在皮肤上而造成的伤害，导致皮肤软化和破裂。

Prevalence of MARSIs

马拉松病患病率

A recent study published in the Aesthetic Surgery Journal Open Forum in collaboration with the Johns Hopkins University School of Medicine and the University of California San Diego found that current synthetic devices such as the Dermabond Prineo Skin Closure System display a range of adverse events associated with MARSI.

最近与约翰·霍普金斯大学医学院和加利福尼亚大学圣地亚哥分校合作发表在《美容外科杂志开放论坛》上的一项研究发现，目前的合成设备，如Dermabond Prineo皮肤封闭系统，显示出一系列与MARSI相关的不良事件。

The study found the rate of severe allergic contact dermatitis to Dermabond Prineo to be 24% (6/25) which a moderate rate of 52% (13/25) in comparison to a 0% (0/25) reaction rate to a natural silk fibroin dressing. The silk dressing significantly decreased skin discomfort (4% vs. 64%) and reduced the need for topical steroids or antibiotics for the treatment of ACD and SSIs (0% vs.

该研究发现，Dermabond Prineo的严重过敏性接触性皮炎发生率为24%（6/25），与天然丝素蛋白敷料的0%（0/25）反应率相比，中度发生率为52%（13/25）。丝绸敷料显着降低了皮肤不适（4%比64%），减少了局部类固醇或抗生素治疗ACD和SSI的需要（0%比64%）。

52%)..

52%)..

A prospective study in adult intensive care units found the rate of MARSI to be 42% (n=150) while another prospective cohort study found the rate to be 60.3% (n=136) in congenital heart surgery. The rise of synthetic compounds and materials in modern medicine may be associated with this increase in MARSI reported in the literature..

在成人重症监护病房进行的一项前瞻性研究发现，MARSI的发生率为42%（n=150），而另一项前瞻性队列研究发现，先天性心脏手术的发生率为60.3%（n=136）。现代医学中合成化合物和材料的兴起可能与文献报道的MARSI的增加有关。。

Despite these reports, the true rate of MARSI remains uncertain due to the lack of standardized reporting and awareness of the issue in healthcare facilities.

尽管有这些报告，但由于缺乏标准化的报告和对医疗机构问题的认识，MARSI的真实发生率仍然不确定。

Which patients are at the highest risk for MARSI?

哪些患者患MARSI的风险最高？

Infants and elderly patients are at a higher risk for MARSI due to their delicate and fragile skin which can be hypersensitive to irritants and can be easily damaged by adhesive dressing removal. Patients who are dehydrated or malnourished are also at higher risk due to the lack of moisture and nutrients required for skin integrity.

婴儿和老年患者由于其娇嫩脆弱的皮肤而患MARSI的风险更高，皮肤对刺激物过敏，并且很容易被粘合剂敷料去除而损坏。由于缺乏皮肤完整性所需的水分和营养，脱水或营养不良的患者也面临更高的风险。

Underlying medical conditions which can also affect the skin include diabetes, infection, renal insufficiency, and immunosuppression. Individuals with dermatological conditions such as eczema and psoriasis which can cause dry and flaky skin are also at increased risk for MARSI..

也可能影响皮肤的潜在疾病包括糖尿病，感染，肾功能不全和免疫抑制。患有皮肤病（如湿疹和牛皮癣）的人可能会导致皮肤干燥和片状，因此患MARSI的风险也会增加。。

The relation between MARSI and surgical site infections

MARSI与手术部位感染的关系

The skin is the largest organ of our bodies and serves as the main protective barrier against the outside world and pathogens. After a surgical procedure the role of wound closures and dressings is to promote the natural healing process to allow the regeneration of the damaged tissue. A MARSI serves as a direct disruption to this process and can delay wound healing for weeks to months after the initial procedure.

皮肤是我们身体最大的器官，是抵御外界和病原体的主要保护屏障。外科手术后，伤口闭合和敷料的作用是促进自然愈合过程，从而使受损组织再生。MARSI直接破坏了这一过程，可以在初始手术后将伤口愈合延迟数周至数月。

Contact dermatitis, blistering, and skin tearing cause the epidermis to detach from the dermis, leading to prolonged inflammation and an increased risk of Surgical Site Infections (SSIs). SSIs can cost up to $29,000 per incident and increase hospitalization stays an additional 7 to 11 days longer. They also incur cumulative costs of up to $10 billion annually.

接触性皮炎，起泡和皮肤撕裂会导致表皮与真皮分离，导致炎症持续时间延长，并增加手术部位感染（SSI）的风险。SSI每次事故的费用高达29000美元，住院时间延长7至11天。它们每年的累积成本也高达100亿美元。

Reducing the prevalence of MARSIs are crucial in minimizing the serious dangers and costs associated with SSIs..

减少MARSIs的流行对于最大程度地减少与SSI相关的严重危险和成本至关重要。。

Treatment and preventative measures against MARSI

MARSI的治疗和预防措施

The selection of the correct wound dressings and closure devices for patients remains an important factor in preventing MARSIs. Clinicians should consider patient risk factors, skin integrity, patient allergies and the location of the wound. Improper removal techniques can lead to mechanical skin tears.

为患者选择正确的伤口敷料和闭合装置仍然是预防MARSIs的重要因素。临床医生应考虑患者的危险因素，皮肤完整性，患者过敏和伤口位置。不正确的去除技术可能导致机械性皮肤撕裂。

Adhesive dissolvers may be utilized to mitigate this concern. Leaving on occlusive dressings for extended periods of time may also result in MARSI..

可以使用粘合剂溶解剂来缓解这种担忧。长时间使用封闭敷料也可能导致MARSI。。

Photo: Pramote Polyamate, Getty Images

照片：葛蒂图片社Pramote Polyamate

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Digital Medicine Conference You Don’t Want to Miss

不想错过的数字医学会议

NODE.Health 7th annual conference. December 6-8, 2023, Microsoft NYC, NY. 30% off for MedCity News readers.

节点。健康第七届年会。2023年12月6日至8日，微软纽约。MedCity新闻读者可享受七折优惠。

NODE.Health

节点。健康

BioLabs Pegasus Park Cultivates Life Science Ecosystem

生物实验室飞马座公园培育生命科学生态系统

Gabby Everett, the site director for BioLabs Pegasus Park, offered a tour of the space and shared some examples of why early-stage life science companies should choose North Texas.

BioLabs Pegasus公园的场地主任加比·埃弗雷特（GabbyEverett）提供了一次太空之旅，并分享了一些早期生命科学公司为什么应该选择北德克萨斯州的例子。

Stephanie Baum

斯蒂芬妮·鲍姆