Peristomal skin complications are common in patients following a laryngectomy because of the repeated use of devices requiring medical adhesive. Medical adhesive-related skin injury (MARSI) is increasingly recognised as a preventable source of pain, infection risk and reduced quality of life. Laryngectomy patients are particularly vulnerable owing to age-related skin changes, radiotherapy, malnutrition and prolonged moisture exposure. Historically, MARSI has been accepted as an unwelcome side effect of care in this patient group. This article explores the pathophysiology of MARSI, risk factors specific to the laryngectomy population and the importance of preserving the skin's acid mantle. Best practice in prevention and management includes optimal adhesive removal techniques, and selecting an appropriate adhesive and barrier products. Integrating a structured peristomal skin assessment tool into clinical practice would support speech and language therapists and clinical nurse specialists in the early identification of skin problems, prompt adapted care and facilitate patient education. A proactive approach is essential to minimise skin injury and improve overall patient outcomes.
Alexandra J Bishop (Wed,) studied this question.