Medical Adhesives in the NICU

Skin injury from medical adhesives is a known problem for neonatal intensive care unit (NICU) patients. Medical adhesive-related skin injury (MARSI) for all patient populations includes mechanical problems such as skin stripping, skin tears, and tension blisters; dermatitis reactions such as irritant contact dermatitis and allergic dermatitis; and other complications such as skin maceration and folliculitis. The most common seen in neonatal patients is epidermal or skin stripping; chronically hospitalized infants may also experience irritant contact dermatitis to a variety of adhesive products. Preventing MARSI is the goal, using the fewest and least irritating adhesive products; yet, secure fixation of medical life support equipment is imperative. This article will explore differences in neonatal skin that place NICU patients at risk for MARSI and selecting products that are most appropriate for the desired result. Barrier films and adhesive removers are also discussed in detail to determine which may be potentially beneficial to the NICU population.