title: Medical Adhesive-Related Skin Injury Following Emergent Appendectomy: A Case Study of MARSI and Missed Opportunities in Nursing Care.
abstract: BACKGROUND
  The potential for skin damage from adhesive products is documented in the literature. Nevertheless, health care providers continue to lack understanding of the impact and seriousness of skin injury associated with use of tapes or other adhesive devices when applied to a patient with a history or hypersensitivity or allergy to adhesives.
  
  
  METHODS
  A 67-year-old woman with a history of tape allergy underwent emergency appendectomy. Initial removal of an adhesive bandage placed over the surgical incision revealed medical adhesive-related skin injury (MARSI). The largest of the 3 wounds was a Class III skin tear based on the Payne-Martin Classification System. It measured (L) 4.4 cm × (W) 1.8 cm × (D) 0.3 cm and required 3 months to heal.
  
  
  CONCLUSIONS
  Experiences with this case revealed the need for evidence-based practice innovations to prevent physical, emotional, and economic cost resulting from MARSI. We recommend early identification and careful documentation of susceptibility to MARSI prior to surgery and implementation of consensus-based recommendations for prevention of MARSI as advocated by the MARSI consensus group when preparing patients for surgery and treating wounds.
authors.affiliation: Sylvia E. Britt, PhD, RN, School of Nursing, University of Alabama at Birmingham, Alabama. Karen M. Coles, DNP, RN, School of Nursing, University of Alabama at Birmingham, Alabama. Shannon S. Polson, MSN, RN, CWCN, CFCN, CNL, School of Nursing, University of Alabama at Birmingham, Alabama.
authors.forename: Sylvia E
authors.initials: SE
authors.lastname: Britt
authors.forename: Karen M
authors.initials: KM
authors.lastname: Coles
authors.forename: Shannon S
authors.initials: SS
authors.lastname: Polson
mesh_terms: D000269:Adhesives / Q000009:adverse effects*; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001062:Appendectomy / Q000009:adverse effects*; D001458:Bandages / Q000009:adverse effects; D000075202:Contraindications; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000209:etiology*; D012837:Silver Sulfadiazine / Q000494:pharmacology / Q000627:therapeutic use; D012867:Skin / Q000293:injuries*; D014945:Wound Healing / Q000187:drug effects*; D047071:beta-Glucans / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000269:Adhesives; D000900:Anti-Bacterial Agents; D047071:beta-Glucans; C067858:beta-glucan, (1-3)(1-4)-; D012837:Silver Sulfadiazine