- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT07697430
Medical Adhesive and Barrier Products for Preventing MARSI in Central Venous Catheter Dressings
Effect of Medical Adhesive and Skin Barrier Products Used for Central Venous Catheter Dressings on the Development of Medical Adhesive-Related Skin Injury: A Randomized Controlled Trial
The goal of this clinical trial is to compare three different dressing securement strategies used for central venous catheters (CVCs) to determine which is more effective in preventing medical adhesive-related skin injury (MARSI) among adults admitted to a Chest Diseases Intensive Care Unit.
The main questions it aims to answer are:
Does the type of dressing securement affect the occurrence of MARSI? Which dressing securement strategy is most effective in preventing CVC-related MARSI?
Researchers will compare:
acrylic adhesive tape, silicone adhesive tape, and barrier film combined with acrylic adhesive tape to determine which dressing securement strategy provides the best protection against CVC-related MARSI.
Participants will:
be randomly assigned to one of the three dressing securement strategies, receive the assigned dressing securement throughout the study period, undergo regular skin assessments for signs of MARSI, and be followed for up to 21 days or until catheter removal.
Přehled studie
Postavení
Detailní popis
Medical adhesive-related skin injury (MARSI) is a preventable complication caused by the application or removal of medical adhesives used to secure medical devices. MARSI includes skin stripping, skin tears, blistering, contact dermatitis, folliculitis, and maceration, and may lead to pain, impaired skin integrity, increased infection risk, unplanned dressing replacement, prolonged hospitalization, and increased healthcare costs.
Patients with central venous catheters (CVCs), particularly those admitted to intensive care units, are at increased risk of MARSI because of repeated dressing changes, prolonged exposure to adhesive products, impaired skin integrity, and multiple intrinsic and extrinsic risk factors. Previous studies have reported that the incidence of CVC-related MARSI ranges from approximately 11% to 32%, with the cervical region being the most commonly affected anatomical site.
Although various adhesive and skin protection products are available for CVC securement, evidence directly comparing their effectiveness in preventing CVC-related MARSI remains limited. Most previous studies have been observational, included relatively small sample sizes, had short follow-up periods, or evaluated skin injury as a secondary outcome rather than a primary endpoint. Consequently, there is insufficient high-quality comparative evidence to guide the selection of the most effective securement strategy for preventing MARSI in patients with CVCs.
This prospective, single-center, three-arm, parallel-group, randomized controlled trial is designed to compare the effectiveness of acrylic adhesive tape, silicone adhesive tape, and barrier film combined with acrylic adhesive tape in preventing CVC-related MARSI. Adult patients requiring an internal jugular CVC will be randomly assigned in a 1:1:1 ratio to one of the three intervention groups using stratified block randomization based on age and sex. Because the interventions are visually distinguishable, participant and care provider blinding is not feasible. Group allocation will be concealed from the statistician during data analysis. Participants will be followed for up to 21 days or until catheter removal.
The primary objectives are to compare the occurrence and incidence of CVC-related MARSI among the intervention groups. Secondary objectives are to compare the time to MARSI development, MARSI severity, and MARSI type. The findings of this study are expected to provide high-quality comparative evidence to support evidence-based nursing practice and identify the most effective adhesive securement strategy for preventing CVC-related MARSI among adult patients admitted to a Chest Diseases Intensive Care Unit.
Typ studie
Zápis (Odhadovaný)
Fáze
- Nelze použít
Kontakty a umístění
Studijní místa
-
-
Center
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Afyonkarahisar, Center, Turecko (Türkiye), 03030
- Nábor
- Afyonkarahisar Health Sciences University Health Practice and Research Center
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Kontakt:
- Azize Ozdas Gundogan, RN, MSc
- Telefonní číslo: +90533 615 36 55
- E-mail: azize.ozdas@afsu.edu.tr
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Vrchní vyšetřovatel:
- Ibrahım Guven Cosgun, MD
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
- Dospělý
- Starší dospělý
Přijímá zdravé dobrovolníky
Popis
Inclusion Criteria:
- Adults aged 18 years or older. Patients admitted to the Chest Diseases Intensive Care Unit who are undergoing insertion of an internal jugular central venous catheter.
Central venous catheter inserted by a physician using sterile technique in the intensive care unit or operating room.
Intact skin at the catheter insertion site, with no pre-existing skin injury or dermatological disease.
Written informed consent provided by the participant or a legally authorized representative.
Exclusion Criteria:
- Active or congenital dermatological disease. Known allergy or hypersensitivity to the study dressings or skin barrier film. Clinically significant hyperhidrosis. Central venous catheter inserted through a site other than the internal jugular vein (e.g., subclavian or femoral vein).
Patients requiring contact isolation (e.g., scabies) or airborne isolation (e.g., tuberculosis).
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Prevence
- Přidělení: Randomizované
- Intervenční model: Paralelní přiřazení
- Maskování: Žádné (otevřený štítek)
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
|---|---|
|
Experimentální: Acrylic Adhesive Tape
Participants will receive central venous catheter securement using an acrylic adhesive tape according to the standardized dressing protocol.
Dressing application, assessment, and replacement will be performed following the study protocol throughout catheterization.
|
A physician will insert a non-tunneled internal jugular central venous catheter using sterile technique and secure the catheter to the skin with sutures according to routine clinical practice.
Following skin antisepsis, the insertion site will be covered with sterile 2 × 2 cm gauze and secured with a 10 × 10 cm acrylic adhesive tape.
Dressings will be changed every 24 hours or earlier if clinically indicated.
Participants will be followed for up to 21 days or until catheter removal, with assessment for medical adhesive-related skin injury (MARSI) at each dressing change.
|
|
Experimentální: Silicone Adhesive Tape
Participants will receive central venous catheter securement using a silicone adhesive tape according to the standardized dressing protocol.
Dressing application, assessment, and replacement will be performed following the study protocol throughout catheterization.
|
A physician will insert a non-tunneled internal jugular central venous catheter using sterile technique and secure the catheter to the skin with sutures according to routine clinical practice.
Following skin antisepsis, the insertion site will be covered with sterile 2 × 2 cm gauze and secured with a 10 × 10 cm silicone adhesive tape.
Dressings will be changed every 24 hours or earlier if clinically indicated.
Participants will be followed for up to 21 days or until catheter removal, with assessment for medical adhesive-related skin injury (MARSI) at each dressing change.
|
|
Experimentální: Barrier Film + Acrylic Adhesive Tape
Participants will receive a skin barrier film before application of an acrylic adhesive tape for central venous catheter securement according to the standardized dressing protocol.
Dressing application, assessment, and replacement will be performed following the study protocol throughout catheterization.
|
A physician will insert a non-tunneled internal jugular central venous catheter using sterile technique and secure the catheter to the skin with sutures according to routine clinical practice.
Following skin antisepsis, the insertion site will be covered with sterile 2 × 2 cm gauze.
A skin barrier film will be applied to the surrounding skin and allowed to dry before securing the dressing with a 10 × 10 cm acrylic adhesive tape.
Dressings will be changed every 24 hours or earlier if clinically indicated.
Participants will be followed for up to 21 days or until catheter removal, with assessment for medical adhesive-related skin injury (MARSI) at each dressing change.
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Incidence of Medical Adhesive-Related Skin Injury (MARSI)
Časové okno: From randomization until catheter removal or up to 21 days, assessed at every dressing change (every 24 hours).
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Incidence of medical adhesive-related skin injury (MARSI) at the central venous catheter dressing site, classified according to the international consensus recommendations (mechanical injury, dermatitis, or other skin injuries).
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From randomization until catheter removal or up to 21 days, assessed at every dressing change (every 24 hours).
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
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Time to First Medical Adhesive-Related Skin Injury
Časové okno: From randomization until catheter removal or up to 21 days.
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Time from catheter dressing application to the first occurrence of medical adhesive-related skin injury.
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From randomization until catheter removal or up to 21 days.
|
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Severity of Medical Adhesive-Related Skin Injury
Časové okno: From randomization until catheter removal or up to 21 days, assessed at every dressing change (every 24 hours).
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Severity of MARSI classified as mild, moderate, or severe according to the Wang et al. grading system.
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From randomization until catheter removal or up to 21 days, assessed at every dressing change (every 24 hours).
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Type of Medical Adhesive-Related Skin Injury
Časové okno: From randomization until catheter removal or up to 21 days, assessed at every dressing change (every 24 hours).
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Type of medical adhesive-related skin injury (MARSI) classified according to the international consensus as mechanical injury, dermatitis, maceration, folliculitis, or other skin injuries.
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From randomization until catheter removal or up to 21 days, assessed at every dressing change (every 24 hours).
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Spolupracovníci a vyšetřovatelé
Sponzor
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Odhadovaný)
Dokončení studie (Odhadovaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
- Jednotka intenzivní péče
- Randomizovaná kontrolovaná zkouška
- Ošetřovatelství
- Centrální žilní katétr
- Bariérový film
- MARSI
- Medical Adhesive Related Skin Injury
- Central Venous Catheter Dressing
- Acrylic Adhesive Tape
- Silicone Adhesive Tape
- Skin Injury
- medical adhesive tapes
- Central venous catheter dressing fixation
Další identifikační čísla studie
- EÜ-SBE-HE-93220000072-CIP-01
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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