You may have heard of the term MARSI…. but what does it mean?
The term refers to Medical Adhesive-Related Skin Injuries essentially the damage caused to your skin by removing adhesive dressings or stoma appliances. Everyone knows that removing plasters can be painful, especially if you have an area of skin which is sore (or hairy!), there is even a metaphor ‘Ripping off the Band-Aid’ the implication is that a short sharp pain is preferable to a longer lesser pain. The effect is pain non the less.
MARSI with stoma appliances can be an issue because stoma appliances must have an effective adhesive to ensure that the appliance stays in position and prevents leakage of stoma output. In addition, many people change their stoma appliances regularly, perhaps once every day so the application and removal of the appliance will be repeated on a regular basis.
What injuries can occur and how will that affect the skin around my stoma?
When the adhesive appliance is removed superficial layers of skin cells can also be removed causing injury and pain. This is referred to as ‘skin stripping’. These layers of skin cells are part of the stratum corneum the outer most layers of skin. Injury can also occur where the top layer of skin is separated from the epidermis, and this causes a deeper skin injury.
The main function of the skin is to act as a physical barrier against the external environment and to prevent harmful substances and infection from entering the body. In addition, the skin acts as a moisture barrier preventing excessive fluid gain or loss from the body.
When the skin integrity is compromised, damaged skin will need to heal and can be open to infection.
In addition, when the skin is damaged it is not able to adequately manage water balance. Trans epidermal water loss (TEWL) can occur leading to a moist or wet area on the skins surface. Increased moisture can prevent the next adhesive appliance from attaching effectively, this in turn increases the possibility of leakage and a cycle of further damage.
It is important that your peristomal skin is kept as intact and healthy as possible and your appliances need to be removed gently and with care. This is particularly important if you have fragile skin, children for example have delicate skin as do older people.
How can I look after my peristomal skin and prevent MARSI?
Take care when removing your appliances making sure you do not remove them too quickly or harshly. You may have been prescribed an adhesive remover spray or adhesive remover wipes. These products will allow you to remove the appliance easily with minimum force.
Adhesive remover wipes are very helpful if you have a build-up of adhesive residue on your skin from the use of adhesive appliances, seals or stoma paste. The individual sachets are also handy to have in your bag or car to use whilst travelling out and about.
If you would like samples of our StoCare Remove spray or wipes please order from our sample request page.
