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Abstract

Background: Medical adhesive-related skin injury (MARSI) is a common complication associated with acrylic-based adhesive removal. Topical agents such as 0.9% NaCl (normal saline), white petrolatum, and 70% alcohol are commonly used to assist adhesive removal; however, their effectiveness in reducing MARSI remains unclear.

Methods: This single-blind randomized controlled trial with a within-subject design included 56 healthy adults. Acrylic-based adhesives were applied to four sites on the upper arms. Adhesive removal was performed on days 3 and 6 using three interventions (normal saline, petrolatum, alcohol) and one control (no topical agent). Outcomes included MARSI incidence, clinical erythema score, erythema index, transepidermal water loss (TEWL), and pain assessed using a visual analog scale (VAS).

Results: Overall, MARSI incidence was 49.5% on day 3 and 59.3% on day 6 across all three interventions and the control group. No statistically significant difference in incidence was observed between intervention and control groups (p = 0.421). Alcohol demonstrated more consistent improvement in erythema-related parameters, including lower clinical erythema scores and reduced erythema index (p = 0.024). Changes in TEWL and pain scores did not differ significantly across groups.

Conclusion: The use of topical agents did not significantly reduce the incidence of MARSI. However, alcohol showed more favorable effects on erythema-related parameters and pain. This study was limited by its single-center design, short observation period, and inclusion of healthy adult subjects, which may limit generalizability.

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