Medical Adhesive-Related Skin Injury: Prevalence, Risk Factors, Prevention and Mitigation: A Systematised Literature Review

Background: Medical adhesives are widely used, and have an invaluable role in securement of medical devices and management of wounds. However, medical adhesive-related skin injuries, MARSI, are a common occurrence adversely affecting patient and provider outcomes.

Methods: A systematised review of empirical literature relating to MARSI was undertaken (timespan 2015-2026; all ages; all study designs; all geographic locations). Structured searches of CINAHL Ultimate, Cochrane Library including CENTRAL and PubMed were undertaken between October 2025 and January 2026. Studies were screened for eligibility, using the PRISMA methodology, following defined inclusion and exclusion criteria. Narrative synthesis was undertaken.

Results: The searches yielded 403 articles. After screening, 45 eligible studies remained, 25 addressing MARSI prevalence and risk factors and 20 relating to MARSI prevention and mitigation; marked heterogeneity precluded meta-analysis. There was wide geographic variation, with low- and middle-income countries under-represented. Studies were conducted in a wide range of settings and clinical specialisms, particularly high-dependency and critical care; only one study involved primary and long-term care facility settings. MARSI prevalence was generally high (median 28.0%, range 0.85%- 70.21%) and influenced by such factors as adhesive type, dressing duration and patient condition. Fifteen prevention and mitigation studies were trials; 11/15 addressed adhesive tapes, dressing and securement products. Silicone-based products generally demonstrated lower MARSI incidence. Risk stratified assessments and standardised skin care protocols demonstrated benefits. Limitations of the evidence reviewed included generally small sample sizes; preponderance of single site studies; lack of consistency in definitions, assessments and outcomes and limited adoption of relevant methodological guidelines.

Conclusions: Findings reaƯirm MARSI as a common and clinically significant complication. Patient vulnerability, clinical context and adhesive/product type influence prevalence. Silicone-based adhesives may be an appropriate first-line option for frail and vulnerable patients. Risk stratified care pathways show promise. Proactive steps are required to minimise adhesive use where feasible and manage risk where not. Highquality, multi-centre studies are needed, as is standardisation in studies. There is a dearth of MARSI research in low - and middle - income countries and in primary care/long term care facilities.