[Skin care and skin protection in preterm babies]

The skin of preterm infants is anatomically and physiologically premature. This quality of the skin as well as the need for intensive monitoring and treatment/care represent additional stress factors for the integrity of the babies' skin. The babies have an increased vulnerability and risk of skin injuries. Therefore, during the first two to three weeks of life observation of the premature skin is of utmost importance. Ritualistic activities have to be questioned. This is particularly true for infants who are born before 28 weeks of pregnancy. This systematic literature review investigates the effectiveness of nursing interventions in the skin care and protection of the premature infants born earlier than the 32nd week of pregnancy. A systematic literature-search in different databases addressed the following topics: Skin-assessment, selection and use of adhesives, skin care with emollients, and body cleaning (wash interval). Despite certain methodological problems with some of the studies included in this review the following results can be formulated: Based on altered infant behaviour and the skin's continuously high population of germs the interval of bathing should be enhanced to four days. During the first two to four weeks of life the application of sun flower oil is recommended. It has a disinfecting effect and is relatively cheap. Potential preventive or protective dressings of the skin are recommended. Similarly both the utilisation of a valid skin assessment instrument and of preventive measures are inevitable.

Evidence-based knowledge of the needs and care of premature skin could reduce complications during the neonatal phase and therefore health care costs. The implementation of a standardised, evidence-based skin care guideline could raise the health professionals' awareness in of skin care needs in this vulnerable patient group.