Every year, an estimated 1.5 million patients in the United States suffer from Medical Adhesive-Related Skin Injuries, or MARSI. Yet despite being one of the most common complications in healthcare settings, MARSI remains largely unknown to the general public and underreported in clinical environments. If you or someone you care for has sensitive, fragile, or aging skin, understanding MARSI could be the key to preventing painful and potentially serious skin damage.
What Is MARSI?
MARSI (Medical Adhesive-Related Skin Injury) is defined as any skin damage that occurs as a result of removing medical adhesive products. This includes adhesive bandages, medical tape, wound dressings, EKG electrodes, IV securing devices, and any other product that adheres to the skin using medical adhesive.
The key distinction is that MARSI refers specifically to damage caused by the removal of the adhesive — not by the adhesive itself while it’s in place. When a bandage or tape is pulled from the skin, the mechanical force can exceed the structural integrity of the skin, resulting in injury.
Types of MARSI
MARSI encompasses several distinct types of skin injury:
1. Skin Stripping (Epidermal Stripping)
The most common form of MARSI. When adhesive is removed, it can strip away the outermost layer of skin (epidermis), leaving a raw, painful surface that resembles a superficial burn. This is particularly common in elderly patients whose skin has thinned significantly with age.
2. Skin Tears
More severe than stripping, skin tears involve partial or full-thickness tears in the skin. These can create wounds that require additional treatment and are at risk of infection. Skin tears are categorized by the Payne-Martin classification system:
- Category I: Linear tears with the skin flap intact and able to be repositioned
- Category II: Skin flap partially lost
- Category III: Complete skin flap loss, exposing wound bed
3. Tension Blisters/Injuries
Caused by skin being stretched or pulled by adhesive tension. Fluid-filled blisters form between skin layers, which can rupture and create open wounds.
4. Irritant Contact Dermatitis
A non-allergic inflammatory reaction caused by repeated application and removal of adhesives. Symptoms include redness, itching, burning, and skin breakdown.
5. Allergic Contact Dermatitis
An immune-mediated reaction to specific chemicals in the adhesive (such as acrylates, colophony, or rubber accelerators). This produces a delayed hypersensitivity reaction with intense itching, redness, and blistering.
6. Maceration
Softening and breakdown of skin caused by trapped moisture under non-breathable adhesives. Macerated skin is white, wrinkled, and extremely vulnerable to tearing.
7. Folliculitis
Inflammation or infection of hair follicles caused by adhesive pulling on hair during removal.
Who Is Affected by MARSI?
While MARSI can affect anyone, certain populations are at significantly higher risk:
Elderly Adults (65+)
The highest-risk group. Age-related skin changes — including thinning of the epidermis, collagen loss, decreased oil production, and reduced blood flow — make elderly skin exceptionally vulnerable to adhesive trauma. Studies show that skin tears affect up to 1.5 million nursing home residents annually.
Patients on Blood Thinners
Anticoagulants (warfarin, Eliquis, Xarelto, Pradaxa, Plavix) reduce the skin’s ability to withstand mechanical stress. Even gentle adhesive removal can cause bruising, and more forceful removal can cause significant tearing and bleeding.
Cancer Patients
Chemotherapy and radiation therapy severely compromise skin integrity. Cancer patients undergo frequent bandage changes (for IV sites, port access, surgical sites, blood draws) with skin that is at its most vulnerable state.
Neonates and Infants
Premature and newborn skin is structurally immature and extremely vulnerable to adhesive trauma. NICU patients are at particular risk due to the number of monitoring devices and IV sites requiring adhesive attachment.
Chronic Wound Patients
Patients with diabetic ulcers, venous stasis ulcers, or pressure injuries undergo frequent dressing changes. The surrounding skin, often already compromised, experiences cumulative adhesive damage with each change.
Patients with Skin Conditions
Eczema, psoriasis, epidermolysis bullosa, and other dermatologic conditions reduce skin barrier function and increase vulnerability to MARSI.
The Hidden Costs of MARSI
MARSI isn’t just painful — it’s expensive. The costs include:
- Extended hospital stays: Skin injuries can delay discharge and require additional treatment
- Additional wound care supplies: Treating MARSI injuries requires more dressings, medications, and nursing time
- Infection treatment: Open MARSI wounds are vulnerable to infection, potentially requiring antibiotics
- Patient pain and anxiety: MARSI creates fear of future bandage changes, leading to treatment avoidance
- Legal liability: Healthcare facilities can face liability for preventable MARSI events
How to Prevent MARSI
1. Choose the Right Adhesive Products
The single most effective MARSI prevention strategy is using adhesive products designed for safe removal. Comfort Release® bandages use patented OGS (Oligomeric Switch) technology that allows completely painless, trauma-free removal using rubbing alcohol. The alcohol dissolves the adhesive bond, eliminating all mechanical force from the skin surface.
2. Proper Application Technique
- Apply adhesives without tension or stretching
- Use the minimum adhesive coverage necessary
- Ensure skin is clean and dry before application
- Apply skin protectant to peri-wound skin before adhesive application
3. Proper Removal Technique
- Remove adhesives slowly, pulling parallel to the skin (not perpendicular)
- Support surrounding skin with one hand while removing with the other
- Pull in the direction of hair growth
- Or use Comfort Release® technology: swipe with alcohol for 3-10 seconds for zero-force removal
4. Skin Assessment
- Assess skin condition before every adhesive application
- Document any existing skin damage or risk factors
- Monitor adhesive sites for signs of irritation
- Rotate adhesive application sites when possible
5. Staff Education
Healthcare facilities should implement MARSI prevention protocols including:
- Training on proper adhesive application and removal techniques
- Standardized skin assessment tools
- MARSI reporting and documentation procedures
- Availability of sensitive skin adhesive products for at-risk patients
Comfort Release®: The MARSI Prevention Solution
Comfort Release® bandages represent the most effective MARSI prevention technology available. Here’s why:
- Zero mechanical force during removal: The patented alcohol-release mechanism eliminates all pulling, peeling, and tearing forces
- Hospital-grade adhesion: Unlike silicone alternatives that often fall off, Comfort Release® stays securely in place for up to 7 days
- Clinically validated: 94% satisfaction in studies with 200+ participants, including elderly and pediatric populations
- HCPCS approved: Eligible for insurance reimbursement in healthcare settings
- Available in multiple sizes: 2″x4″ large, 1″x3″ standard, and 1″ circular for all wound types
MARSI Awareness Resources
If you’re a healthcare professional looking to implement MARSI prevention in your facility, the following resources can help:
- The International Skin Tear Advisory Panel (ISTAP) provides clinical guidelines for skin tear prevention and management
- The Wound, Ostomy and Continence Nurses Society (WOCN) offers continuing education on adhesive-related injuries
- Comfort Release® offers in-service training materials and sample packs for healthcare facilities — contact us at 888-929-7555
Conclusion
MARSI is a preventable problem that affects millions of patients every year. By understanding the risk factors, implementing proper techniques, and choosing adhesive products designed for safe removal, healthcare providers and caregivers can dramatically reduce MARSI incidence. Comfort Release® bandages offer the most advanced solution available, combining strong adhesion with truly painless removal for the first time in adhesive bandage history.
For more information about MARSI prevention or to request samples for your healthcare facility, call 888-929-7555 or email info@ComfortRelease.com.