Critically ill patients are more vulnerable to medical adhesive-related skin injuries (MARSI), whose prevention is a constant challenge and one of the main quality indicators of nursing care. MARSI associated with indwelling urinary catheter (IUC) fixation is a relevant adverse event, mainly because of the constant involuntary traction and high skin vulnerability of the fixation site. Silicone adhesive tape has appreciable qualities for fragile skin among the range of adhesives, leading to the inference that it reduces the risk of MARSI.
To compare silicone adhesive tape for IUC fixation with acrylate tape regarding its safety and efficacy.
This was a randomized controlled trial blinded to the patients and evaluator. Data were collected from an intensive care unit (ICU) of a tertiary university hospital in Brazil. Patients with IUC and no MARSI at the fixation site were considered eligible. The omega (Ω) fixation technique was used for IUC fixation. A total of 132 participants were enrolled and divided into two research groups: 66 patients in the intervention group (silicone tape) and 66 in the control group (acrylate tape). Outcomes were the incidence of MARSI, patient outcome in the ICU and hospital and partial, total and overall spontaneous detachment of the tapes.
The overall incidence of MARSI was 28%, with 21% in the silicone group and 35% in the acrylate group, with no statistically significant difference (p = .121), including the severity of the lesions (p = .902). However, partial (p = .003) and overall (p < .001) detachment of the tapes were more frequent in the silicone group.
Silicone tape is no safer than acrylate tape for IUC fixation and is less adhesively effective.
There is no evidence to support the extensive use of silicone tape in this context.
Nursing in critical care. 2023 Jun 01 [Epub ahead of print]
Fabiana Martins de Paula, Oleci Pereira Frota, Juliana Silva Ruiz, Isabela Cassão Braulio, Fernanda Carvalho do Nascimento Gonçalves, Marcos Antonio Ferreira-Júnior, Helena Megumi Sonobe, Danielle Neris Ferreira, Carolina Mariano Pompeo, Alvaro Francisco Lopes de Sousa
School of Nursing, Federal University of Mato Grosso do Sul, Campo Grande, Brazil., Ribeirao Preto College of Nursing, University of Sao Paulo, Ribeirão Preto, Brazil., Maria Aparecida Pedrossian University Hospital, Campo Grande, Brazil., Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, Sao Paulo, Brazil.