HIPEC with cisplatin in a patient with a prior hypersensitivity reaction to systemic oxaliplatin

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

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.

Medical adhesive-related skin injury in cancer patients: A prospective cohort study

Objective:

to estimate the incidence of medical adhesive-related skin injury in the peripheral venous catheter fixation region in critical cancer patients, to identify risk factors, and to establish a risk prediction model for its development.

Method:

a prospective cohort study with a sample of 100 adult and aged patients hospitalized in an intensive care unit. The data were analyzed using descriptive, bivariate and multivariate statistics with Cox regression.

Results:

the incidence of medical adhesive-related skin injury was 31.0% and the incidence density was 3.4 cases per 100 people-days. The risk factors were as follows: alcoholism, smoking habit, hospitalization due to deep vein thrombosis, acute respiratory failure, immediate postoperative period, heart disease, dyslipidemia, use of antiarrhythmics, blood transfusion, friction injury, pressure injury, turgor, edema, hematoma, petechiae, low values in the Braden scale, clinical severity of the patient, elasticity, moisture, texture and color. The predictive model consisted in the following: decreased skin turgor, presence of hematoma and edema.

Conclusion:

medical adhesive-related skin injury at the peripheral venous catheter insertion site has a high incidence in critical cancer patients and is associated with decreased turgor, presence of hematoma and edema, evidence that can support the clinical practice.