MARSI

Annotations:

• erythema, blistering, vesicles, bulla, erosion, tear

1. Intrinsic risk factors
   1. Age extremes
   2. Skin changes
   3. Dehydration, poor nutrition, reduced sensation, altered mobility, cognitive impairment
2. Extrinsic risk factors
   1. mechanical trauma
   2. soap
   3. dry skin
   4. immobility
   5. Environmental factors- furniture

1. Exposure
   1. alcohol
   2. bleach
   3. solvents
   4. deodorants
   5. soaps
   6. cosmetics
2. Erythema/edema; vesicles
3. TEWL normalizes in 6-12 days

1. Immune-mediated
2. Antigen-specific
   1. rash, erythema, macules, papules, vesicles, wheals
3. mirrors placement of allergen
4. Patch testing

1. Overhydration of the skin
2. Wrinkling of skin surface and change in skin color
   1. white/grayish

1. Skin-stripping
2. Degree of delamination
   1. adhesive type
   2. peel force
   3. angle and removal speed
3. Deeper stripping-skin tear
   1. Type 1
      1. Linear skin tear: full thickness
      2. Flap type: partial thickness that can be fully approximated
         1. Treatment
            1. appoximate tissue flap
            2. skin barrier film
            3. minimaze dressing removal
            4. non-adherent dressing or low adhesive and high MVTR
            5. place arrow on dressing for removal direction
            6. avoid adhesives
            7. avoid transparent adhesives, hydrocolloids, closure strips
   2. Type 2
      1. Skin tear with partial thickness lostt
      2. Scant tissue loss
      3. Mod to large tissue loss
   3. Type 3
      1. Skin tear with complete tissue loss
      2. Partial thickness, loss of epidermal flap
4. moist/glistening surface

1. Stretching and strapping
2. Shear force lifting the epidermis
3. Unroofed with removal

1. Inflammed hair follicles
   1. Pustules

1. Remove excess hair
2. Clean with no-rinse pH balanced product without a moisturizer or petrolatum
3. Alcohol free liquid barrier
4. Correct application: apply without tension or stretch, firm application to fit contours.
5. Correct removal: push/pull method, low and slow, horizontal, adhesive removers, stretch and release with transparent films

1. tubular elastic net
2. elastic tubular bandage
3. Coban
4. conforming gauze wrap
5. Abdiminal dressing holders