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ABSTRAKLatar belakang: Perekat medis akrilat banyak digunakan dalam layanan kesehatan tetapi kerap menimbulkan
Medical adhesive-related skin injury (MARSI). Pencegahan dapat dilakukan dengan menambahkan larutan NaCl 0,9%, vaselin album, atau alkohol saat pengangkatan. Namun belum didukung oleh penelitian.
Tujuan: Mengetahui efektivitas penambahan bahan topikal dalam prosedur pelepasan perekat akrilat dalam mengurangi angka kejadian MARSI dan parameter objektif terkait.
Metode: Penelitian ini adalah uji klinis acak tersamar tunggal. Dilakukan penempelan perekat akrilat pada empat lokasi di kulit lengan atas dewasa normal. Pada hari ketiga dan keenam perekat diangkat dengan/tanpa menambahkan bahan topikal secara acak pada keempat lokasi dan dilakukan evaluasi angka kejadian MARSI, skor eritema klinis, nilai eritema mexameter, TEWL, dan skor VAS nyeri.
Hasil: Terdapat 224 lokasi uji dari 56 sampel. Angka kejadian MARSI pasca pengangkatan pertama 49,5% dan kedua 59,3%, terendah pada alkohol 50%. Alkohol menunjukkan peningkatan rerata skor eritema terendah baik klinis (p=0,102) maupun mexameter (p=0,024). Alkohol dan vaselin menghasilkan peningkatan nilai TEWL terendah (p=0,709). Alkohol dan NaCl 0,9% tidak bermakna meningkatan skor VAS nyeri (p=0,173 dan p=0,699).
Kesimpulan: Penambahan bahan topikal dapat mengurangi angka kejadian MARSI, namun tidak bermakna secara statistik. Alkohol secara konsisten menunjukkan perubahan parameter terkait yang lebih baik.
ABSTRACTBackground: Acrylic-based tapes are widely used in medicine but frequently associated with medical adhesive-related skin injury (MARSI). Addition of normal saline, vaseline or alcohol in its removal may prevent this, but studies are lacking.
Aim: To determine the effectiveness of topical substances in reducing MARSI and related parameters during the removal of acrylic-based adhesives.
Methods: We conducted a single-blind randomized controlled trial on the skin of normal adults. Tapes were placed on four sites on the upper forearms which were removed on the third and sixth days with/without applying the substances. The incidence, erythema based on clinical scores and mexameter, TEWL, and pain VAS were measured.
Results: We obtained 224 test locations from 56 subjects. The incidence was 49.5% on the third day, increasing to 59.3% on the sixth; it was lower in alcohol group (50%). Alcohol resulted in lower mean of clinical erythema (p=0.102) and mexameter scores (p=0.024). Both alcohol and vaseline gave the lowest TEWL increase (p= 0.709). Alcohol and normal saline was insignificantly increasing pain score (p=0.173 and p=0.699).
Conclusion: Application of substances reduced MARSI incidence, but not statistically significant. Alcohol consistently demonstrated more favorable outcome in MARSI-related parameters.
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