ABSTRACT
Objective To measure the prevalence and analyzed associated factors of medical adhesive-related skin injuries (MARSI) at PICC insertion site in patients with hematologic malignancies. Methods A cross- sectional observational study lasting two weeks was carried out in Department of Hematology. Skin assessment data and photographs of skin were collected during PICC maintenances by the same investigator. The related information was got out from the medical record. The observed skin injuries were classified by the dermatologist and PICC specialized nurse together. MARSI prevalence was calculated. The associated factors were analyzed statistically. Results All of the 153 patients with hematologic malignancies were included. The prevalence of total MARSI at PICC insertion site was 33.99%(52/153), including mechanical skin injury (22.87%,35/153), contact dermatitis (CD) ( 9.80%,15/153), moisture-associated skin damage (0.65%,1/153), folliculitis(0.65%,1/153), respectively. Multivariate analysis identified two independent risk factors for mechanical skin injury including age≥50 years old, P=0.016, odds ratio (OR)=5.919, 95%CI 1.389-25.220 and non-specialist nurses in PICC maintenance, P=0.013, OR=8.333,95%CI 1.566-44.360. History of skin allergies (P=0.000,OR=12.333,95%CI 3.669-41.454) and arsenic trioxide infusion through PICC(P=0.003,OR=4.565,95%CI 1.661-12.547) were associated with CD. Conclusions MARSI at PICC insertion site is a prevalent event in the patients with hematologic malignancies. Epidemiological data and independent risk factors are presented in our study, which provide a basis for future study in this area.
ABSTRACT
Peripherally inserted central catheter (PICC) has become internationally widespread in various healthcare settings (hospital, clinics ,homecare, et al), mainly used for administration of chemotherapy drugs, hypertonic parenteral nutrition solution and infusion therapy in two extreme age patients (neonates, especially in premature infants;elderly), which provides necessary vascular access for medium to longer term transfusion therapy. The risks of complications related with PICC are still existed, and PICC site with impaired skin integrity is prevalent, but described by only paucity of literature. International evidence-based guidelines provide little strategy. Our study was to review PICC site with skin injury in order to better understand the etiology, evolution and familiar with the international nursing dynamics, and identify directions for future research in this field, promote to overcome the nursing conundrum, and provide a basis for construction of guidelines for the skin management of PICC.