![]() ![]() PSA backing materials also affect removal. Detachment requires a combination of manipulating the PSA backing and dissolving the adhesive. The adhesion of hydrocolloid products increases with time, creating the same level of risk for MARSI as a well-adhered acrylate. Because it easily detaches, silicone PSAs aren’t appropriate when adhesion is critical, such as when securing an endotracheal tube. This low-energy connection separates easily from the skin. Silicone adhesives-found in wound dressings and tape-adhere to the rough surfaces of the skin at initial application. Some strongly adhering acrylates place patients at risk for MARSI. ![]() Many medical tapes and some dressings contain acrylate with varying levels of adhesion, making some easier to remove than others. (See Comparing adhesives.)Īs acrylate adhesive warms, it fills in the skin’s rough surfaces. Both the adhesive side of the PSA as well as its backing material play a role in adherence and removal.Īcrylate, silicone, and hydrocolloid are three commonly used adhesives. PSAs are designed to overcome these challenges, while balancing successful adherence and easy removal. The skin’s surface qualities-moisture, hair, oil, and shedding dead cells-make PSA adhesion challenging. This article will look at the qualities of PSA adhesives and backings, explain the principles of removal, and discuss products that aid removal. Our understanding of PSAs and their removal can help prevent harm and patient anxiety. Malnutrition and dehydration-Patients who are malnourished or dehydrated may have weakened skin integrity.Medications-Some drugs, such as corticosteroids, can cause thinning of the skin, which increases a patient’s risk for MARSI and delayed healing.Older adults-As people age, the skin structure weakens and loosens, resulting in separation of the skin layers upon adhesive removal.Newborns-The connection between the epidermis and dermis is weaker than in adults.Before beginning removal, consider these patient factors: ![]() These patients will have a weakened connection between skin layers that may be injured when pressure-sensitive adhesives are removed. Patients with fragile or delicate skin are at risk for medical adhesive–removal skin injury (MARSI). ![]()
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