Risk factors for medical adhesive-related skin injury at the site of peripherally inserted central venous catheter placement in patients with cancer: a single-centre prospective study from China

Abstract

Objectives This study aims to explore the incidence of, and risk factors for medical adhesive-related skin injury (MARSI) at peripherally inserted central venous catheter (PICC) sites in patients with cancer.Design A prospective observational cohort study was conducted at a tertiary hospital in Shenzhen, China.Setting This was a single-centre study conducted in a tertiary hospital in Shenzhen, China.Participants A total of 340 patients with cancer and PICC placement from January 2022 to June 2023 were selected using a convenience sampling method.Methods Factors potentially associated with PICC-related MARSI (PICC-MARSI) were recorded, including patient demographics, and catheter placement and maintenance. Patients were divided into MARSI and non-MARSI groups. Univariate analysis was performed to screen for associated variables, and logistic regression analysis was used to identify independent risk factors for PICC-MARSI.Results Of all 340 patients enrolled, 33 (9.7%) developed PICC-MARSI, including skin tear (8, 24.2%), tension injury (5, 15.2%), irritant contact dermatitis (10, 30.3%), allergic dermatitis (7, 21.2%) and maceration (3, 9.1%). Multivariable analysis showed that age (OR=1.058, p=0.001, 95% CI 1.023–1.094), wet skin (OR=4.873, p=0.003, 95% CI 1.728–13.742), dry skin (OR=6.247, p<0.0001, 95% CI 2.239–17.431), oedema (OR=3.302, p=0.008, 95% CI 1.365–7.985), allergy history (OR=6.044, p=0.001, 95% CI 2.040–17.906), dressing type (OR=3.827, p=0.003, 95% CI 1.595–9.185), body mass index (BMI) <18.5 (OR=4.271, p=0.015, 95% CI 1.327–13.742) and BMI 25–30 (OR=2.946, p=0.027, 95% CI 1.131–7.678) were independent risk factors for PICC-MARSI.Conclusions Proper catheter maintenance and appropriate dressing selection are crucial for the prevention of this condition.