Foreword I n July 2019, a panel of wound care experts, educators and researchers met in the UK to review the literature on medical adhesive-related skin injury and discuss best practice for its assessment and prevention. e two-day meeting resulted in this consensus document, which is intended for anyone who uses adhesive medical devices. e document aims to raise awareness of the widespread occurrence of medical adhesive-related skin injury and the burden it imposes on patients, health professionals and the health service. It seeks to encourage a change in culture, whereby risk assessment and prevention of medical adhesive-related skin injury are considered an integral part of patient care. e document, therefore, provides recommendations for the assessment and prevention of this type of injury, with a view to standardising care across all healthcare settings. It also highlights the need for education on this form of skin damage, which needs to become a core topic in skin care and wound management. Until this happens, there is scope for multidisciplinary teams to provide local training on this subject. In the light of the panel's concern that many health professionals are not only unaware of this avoidable harm but also its abbreviation, MARSI, the term is written in full throughout the document. e panel hopes that implementation of the guidance in this document will reduce avoidable patient su ering and promote better outcomes. Sian Fumarola, Senior Clinical Nurse Specialist, Tissue Viability and Continence, University Hospitals of North Midlands NHS Trust, UK Overview of medical adhesive-related skin injury  'Medical adhesive-related skin injury' is a term used to defi ne any skin damage related to the use of medical adhesive products or devices such as tapes, wound dressings, stoma products, electrodes, medication patches and wound closure strips. This type of injury is largely avoidable

Knowing how biomarker levels vary within biological fluids over time can produce valuable insight into tissue physiology and pathology, and could inform personalised clinical treatment. We describe here a wearable sensor for monitoring biomolecule levels that combines continuous fluid sampling with in situ analysis using wet-chemical assays (with the specific assay interchangeable depending on the target biomolecule). The microfluidic device employs a droplet flow regime to maximise the temporal response of the device, using a screw-driven push-pull peristaltic micropump to robustly produce nanolitre-sized droplets. The fully integrated sensor is contained within a small (palm-sized) footprint, is fully autonomous, and features high measurement frequency (a measurement every few seconds) meaning deviations from steady-state levels are quickly detected. We demonstrate how the sensor can track perturbed glucose and lactate levels in dermal tissue with results in close agreement with standard off-line analysis and consistent with changes in peripheral blood levels.

PURPOSE:The aim of this study was to explore the potential contribution to skin damage caused by standard washing and drying techniques used in nursing.DESIGN: An experimental cohort design was used, with healthy volunteers (n = 15) receiving 6 different washing and drying techniques to the volar aspect of the forearm. Subjects underwent 3 washing and drying techniques on each arm; each technique was repeated twice, separated by a 2-hour rest period. METHODS:Skin integrity was assessed by measuring transepidermal water loss (TEWL), skin hydration, skin pH, and erythema. Comparisons were made between washing with soap or water alone, and drying using a towel (rubbing and patting) or evaporation. The significance of any difference was assessed by nonparametric analysis. The study was approved by the local research ethics committee, and all volunteers gave informed consent. RESULTS:TEWL was seen to increase following each type of wash, and increased further following repeated washing. Drying of the skin by patting with a towel increased TEWL to give readings identical to those obtained from wet skin. There was an increase in skin pH with all washing and drying techniques, particularly when soap was used. Erythema also increased with repeated washing, particularly when soap was used. No significant changes were observed in skin hydration as measured by a corneometer, although there was a tendency for the values to decrease with washing.CONCLUSIONS: These data suggest that washing with soap and water and towel drying has a significant disrupting effect on the skin's barrier function. There is tentative evidence to suggest that a cumulative effect may exist with damage increasing as washing frequency increases. Drying the skin by patting with a towel offers no advantage to conventional gentle rubbing as it leaves the skin significantly wetter and at greater risk of frictional damage. ■ IntroductionThe promotion and maintenance of skin integrity remains one of the most common challenges facing healthcare professionals. Estimates suggest that basic skin care, consisting of washing and drying patients, accounts for 12% to 17% of total nursing time in a typical acute care setting. 1 However, this activity increases significantly during the care of individuals with urinary or fecal incontinence, as washing and drying forms the cornerstone of skin care for this group, in order to prevent irritation and skin breakdown. Globally it is suggested that over 200 million people suffer from significant urinary incontinence, and therefore are at risk of skin breakdown. 2 In the United Kingdom alone, Durrant and Snape 3 suggest that 50% of nursing home residents have urinary incontinence, and overall incidence rates of 40% to 70% in the UK elderly population are reported by the Royal College of Physicians. 4 Early work by Lyder 5 claimed that perineal dermatitis and skin breakdown occurs in 35% of hospitalized elderly patients with incontinence, rising to 41% of individuals in long-term care settings, demonstrating the significance ...

The development of the GLOBIAD is a major step towards a better systematic assessment of IAD in clinical practice and research worldwide. However, further validation is needed.