Abstract：
UNASSIGNED: Medical adhesive-related skin injuries (MARSI), defined as skin damage associated with the use of medical adhesive products or devices, are a common and under-reported condition that compromises skin integrity. The prevention and management of MARSI that can occur around the needle insertion site of a chest wall implantable port in hospitalised patients with a tumour remain challenging issues. The aim of this study was to explore whether the incidence of MARSI could be reduced by changing the body position during dressing changes.
UNASSIGNED: Participants were recruited between May 2019 and November 2020 in the oncology department of a tertiary hospital. Patients were randomly assigned to Group AB (supine followed by semi-recumbent position) and Group BA (semi-recumbent followed by supine position) with a standard intervening recovery interval of 21-28 days. Assessments for typical MARSI included itching, the combination of erythema and oedema, and blisters in the port area, and were graded according to the level of severity.
UNASSIGNED: The itch intensity was significantly lower in phase B (semi-recumbent) compared to phase A (supine) (2.35±1.985 versus 5.31±1.332, respectively; p<0.01). Similarly, the severity of erythema and oedema was less severe when comparing phase B to phase A: grade 0 (64.9% versus 10.5%, respectively); grade 1 (28.1% versus 19.3%, respectively); grade 2 (3.5% versus 7.0%, respectively); grade 3 (1.8% versus 45.6%, respectively); and grade 4 (1.8% versus 17.5%, respectively) (Z=5.703; p<0.01). Blisters were found far less frequently in phase B than phase A (1.8% versus 56.1%, respectively; p<0.01).
UNASSIGNED: The study provided statistically significant evidence that patients in a semi-recumbent position receiving dressing at a chest wall implantable port had fewer and less severe injection site MARSI than when in a supine position.
UNASSIGNED: The authors have no conflicts of interest to declare.
UNASSIGNED: Participants were recruited between May 2019 and November 2020 in the oncology department of a tertiary hospital. Patients were randomly assigned to Group AB (supine followed by semi-recumbent position) and Group BA (semi-recumbent followed by supine position) with a standard intervening recovery interval of 21-28 days. Assessments for typical MARSI included itching, the combination of erythema and oedema, and blisters in the port area, and were graded according to the level of severity.
UNASSIGNED: The itch intensity was significantly lower in phase B (semi-recumbent) compared to phase A (supine) (2.35±1.985 versus 5.31±1.332, respectively; p<0.01). Similarly, the severity of erythema and oedema was less severe when comparing phase B to phase A: grade 0 (64.9% versus 10.5%, respectively); grade 1 (28.1% versus 19.3%, respectively); grade 2 (3.5% versus 7.0%, respectively); grade 3 (1.8% versus 45.6%, respectively); and grade 4 (1.8% versus 17.5%, respectively) (Z=5.703; p<0.01). Blisters were found far less frequently in phase B than phase A (1.8% versus 56.1%, respectively; p<0.01).
UNASSIGNED: The study provided statistically significant evidence that patients in a semi-recumbent position receiving dressing at a chest wall implantable port had fewer and less severe injection site MARSI than when in a supine position.
UNASSIGNED: The authors have no conflicts of interest to declare.
摘要：
■医用胶粘剂相关皮肤损伤（MARSI），定义为与使用医用粘合剂产品或设备相关的皮肤损伤，是一种常见且报道不足的情况，会损害皮肤完整性。在住院的肿瘤患者中，在胸壁可植入端口的针插入部位周围可能发生的MARSI的预防和管理仍然是具有挑战性的问题。这项研究的目的是探讨是否可以通过在换药过程中改变身体位置来降低MARSI的发生率。
■参与者于2019年5月至2020年11月在三级医院的肿瘤科招募。患者被随机分配到AB组（仰卧位，然后是半卧位）和BA组（半卧位，然后是仰卧位），标准的中间恢复间隔为21-28天。典型MARSI的评估包括瘙痒，红斑和水肿的组合，和港口区的水泡，并根据严重程度进行分级。
■与A期（仰卧）相比，B期（半卧位）的瘙痒强度显着降低（分别为2.35±1.985和5.31±1.332；p<0.01）。同样，当比较B期和A期时，红斑和水肿的严重程度较轻：0级（64.9%对10.5%，分别)；一级(28.1%对19.3%，分别)；2级(3.5%对7.0%，分别)；3级(1.8%对45.6%，分别)；和4级(1.8%对17.5%，分别)(Z=5.703；p<0.01)。在B阶段发现水泡的频率远低于A阶段（1.8％对56.1％，分别为；p<0.01)。
■该研究提供了具有统计学意义的证据，表明半卧位在胸壁植入式端口接受敷料的患者与仰卧位相比，注射部位MARSI的严重程度更低。
■作者没有利益冲突要声明。
■参与者于2019年5月至2020年11月在三级医院的肿瘤科招募。患者被随机分配到AB组（仰卧位，然后是半卧位）和BA组（半卧位，然后是仰卧位），标准的中间恢复间隔为21-28天。典型MARSI的评估包括瘙痒，红斑和水肿的组合，和港口区的水泡，并根据严重程度进行分级。
■与A期（仰卧）相比，B期（半卧位）的瘙痒强度显着降低（分别为2.35±1.985和5.31±1.332；p<0.01）。同样，当比较B期和A期时，红斑和水肿的严重程度较轻：0级（64.9%对10.5%，分别)；一级(28.1%对19.3%，分别)；2级(3.5%对7.0%，分别)；3级(1.8%对45.6%，分别)；和4级(1.8%对17.5%，分别)(Z=5.703；p<0.01)。在B阶段发现水泡的频率远低于A阶段（1.8％对56.1％，分别为；p<0.01)。
■该研究提供了具有统计学意义的证据，表明半卧位在胸壁植入式端口接受敷料的患者与仰卧位相比，注射部位MARSI的严重程度更低。
■作者没有利益冲突要声明。
