Objective To evaluate the effect of nursing interventions based on biomechanical characteristics of the skin on prevention of medical adhesive-related skin injuries (MARSI) at PICC insertion site in elderly cancer patients. Methods Ninety elderly cancer patients with PICC lines were randomized into a control group and an intervention group of 45, receiving either conventional PICC maintenance care or alternative interventions based on biomechanical characteristics of the skin. The effect was compared between the two groups after 3 months of intervention. Results The incidence rate of MARSI and time for first-onset of MARSI had significant differences between the two groups (P＜0.05,P＜0.01). Conclusion Provision of PICC line maintenance care based on biomechanical characteristics of the skin can prevent MARSI in elderly cancer patients and protect skin integrity at PICC insertion site.