Effect of Adhesive Dwell Time on Skin Injury in Neonates: A Randomized Controlled Trial.

BACKGROUND

Neonatal skin is immature and highly susceptible to injury, particularly in neonatal intensive care units (NICUs) where medical adhesives are frequently used. Medical adhesive-related skin injury is a common clinical concern, yet evidence regarding optimal adhesive dwell time remains limited.

PURPOSE: This study aimed to evaluate the effect of adhesive dwell time on neonatal skin integrity and its association with skin injury outcomes.

METHODS

A randomized controlled trial was conducted between August and December 2023 in a tertiary NICU. Sixty term neonates (37-40 weeks) were randomized to either a 2-hour adhesive dwell time group (n = 30) or a 4-hour routine care group (n = 30). Skin condition and risk were assessed using the Neonatal Skin Condition Score and the Neonatal Skin Risk Assessment Scale (NSRAS).

RESULTS

The experimental group demonstrated significantly lower Neonatal Skin Condition Scores on Day 1 (P = .010) and Day 3 (P < .001), indicating improved skin condition. No significant between-group differences were observed in NSRAS scores (P > .05), although scores decreased over time in both groups. Birth weight and gestational age were negatively correlated with NSRAS scores in the experimental group (P < .05).

IMPLICATIONS FOR PRACTICE AND RESEARCH: Shorter adhesive dwell time appears to improve neonatal skin condition and may represent a simple and effective strategy to reduce localized skin injury in NICU settings. However, its effect on broader skin risk profiles remains limited. Further research is needed to evaluate long-term outcomes and the interaction between adhesive duration and material type across different neonatal populations.