Medical Adhesive and Barrier Products for Preventing MARSI in Central Venous Catheter Dressings

The goal of this clinical trial is to compare three different dressing securement strategies used for central venous catheters (CVCs) to determine which is more effective in preventing medical adhesive-related skin injury (MARSI) among adults admitted to a Chest Diseases Intensive Care Unit. The main questions it aims to answer are: Does the type of dressing securement affect the occurrence of MARSI? Which dressing securement strategy is most effective in preventing CVC-related MARSI? Researchers will compare: acrylic adhesive tape, silicone adhesive tape, and barrier film combined with acrylic adhesive tape to determine which dressing securement strategy provides the best protection against CVC-related MARSI. Participants will: be randomly assigned to one of the three dressing securement strategies, receive the assigned dressing securement throughout the study period, undergo regular skin assessments for signs of MARSI, and be followed for up to 21 days or until catheter removal.

Inclusion Criteria: * Adults aged 18 years or older. Patients admitted to the Chest Diseases Intensive Care Unit who are undergoing insertion of an internal jugular central venous catheter. Central venous catheter inserted by a physician using sterile technique in the intensive care unit or operating room. Intact skin at the catheter insertion site, with no pre-existing skin injury or dermatological disease. Written informed consent provided by the participant or a legally authorized representative. Exclusion Criteria: * Active or congenital dermatological disease. Known allergy or hypersensitivity to the study dressings or skin barrier film. Clinically significant hyperhidrosis. Central venous catheter inserted through a site other than the internal jugular vein (e.g., subclavian or femoral vein). Patients requiring contact isolation (e.g., scabies) or airborne isolation (e.g., tuberculosis).