MARSI — Medical Adhesive-Related Skin Injury — is a recognized clinical problem affecting millions of patients annually. It happens every time adhesive tape damages skin during removal. For vulnerable populations, it's not a minor inconvenience. It's an iatrogenic injury: harm caused by medical care itself.
The condition is preventable. Understanding who's at risk and what alternatives exist can eliminate MARSI entirely.
What MARSI Looks Like
MARSI manifests in several forms. Skin stripping — the removal of epidermal layers with adhesive. Skin tears — partial or full-thickness wounds from mechanical trauma. Tension blisters — fluid-filled pockets from tape that's applied too tightly. Allergic dermatitis — immune reactions to adhesive chemicals.
All share a common cause: adhesive contacting skin.
Neonates, elderly patients (65+), those on long-term corticosteroids, patients with edema, peripheral vascular disease, diabetes, malnutrition, radiation therapy patients, and anyone on anticoagulant therapy. For these groups, every adhesive application carries risk.
The Mechanism of Injury
Adhesive tape bonds to the stratum corneum — the outermost skin layer. When removed, the adhesive bond may exceed the cohesive strength of the skin itself. Instead of releasing cleanly, the tape pulls skin cells with it.
On healthy adult skin, this causes minor irritation. On compromised skin, it creates wounds.