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Journal of Wound, Ostomy, and... 2015Patients in acute and long-term care settings receive daily routine skin care, including washing, bathing, and showering, often followed by application of lotions,... (Review)
Review
Patients in acute and long-term care settings receive daily routine skin care, including washing, bathing, and showering, often followed by application of lotions, creams, and/or ointments. These personal hygiene and skin care activities are integral parts of nursing practice, but little is known about their benefits or clinical efficacy. The aim of this article was to summarize the empirical evidence supporting basic skin care procedures and interventions and to develop a clinical algorithm for basic skin care. Electronic databases MEDLINE, EMBASE, and CINAHL were searched and afterward a forward search was conducted using Scopus and Web of Science. In order to evaluate a broad range of basic skin care interventions systematic reviews, intervention studies, and guidelines, consensus statements and best practice standards also were included in the analysis. One hundred twenty-one articles were read in full text; 41documents were included in this report about skin care for prevention of dry skin, prevention of incontinence-associated dermatitis and prevention of skin injuries. The methodological quality of the included publications was variable. Review results and expert input were used to create a clinical algorithm for basic skin care. A 2-step approach is proposed including general and special skin care. Interventions focus primarily on skin that is either too dry or too moist. The target groups for the algorithm are adult patients or residents with intact or preclinical damaged skin in care settings. The goal of the skin care algorithm is a first attempt to provide guidance for practitioners to improve basic skin care in clinical settings in order to maintain or increase skin health.
Topics: Algorithms; Dermatitis; Evidence-Based Nursing; Humans; Long-Term Care; Self Care; Skin Care
PubMed: 26165590
DOI: 10.1097/WON.0000000000000162 -
Midwifery Jan 2018to identify what skin practices are important for the protection of baby skin in healthy term babies (0-6 months) and generate evidence-based conclusions to inform... (Review)
Review
OBJECTIVES
to identify what skin practices are important for the protection of baby skin in healthy term babies (0-6 months) and generate evidence-based conclusions to inform health professionals and parents.
DESIGN
eleven databases were searched for all empirical quantitative and qualitative research published between 2000-2015 which explored baby skin care for bathing and cleansing, nappy care, hair and scalp care, management of dry skin or baby massage, for healthy term babies up to 6 months old. Papers not published in English were excluded. A total of 3062 papers were identified. Pairs of reviewers assessed all citations and extracted data independently. There were 26 included papers: 16 RCTs, 3 non-randomised experimental studies, 1 mixed-methods study and 6 qualitative studies. Primary and secondary outcome measures were analysed using meta-analysis or narrative descriptive statistics. Synthesis of qualitative data was not possible due to disparity of the evidence.
FINDINGS
from the small numbers of studies with comparable data, there was no evidence of any significant differences between tested wash products and water or tested baby wipes and water. There was some evidence to suggest that daily use of full-body emollient therapy may help to reduce the risk of atopic eczema in high risk babies with a genetic predisposition to eczema; however, the use of olive oil or sunflower oil for baby dry skin may adversely affect skin barrier function. There was no evidence about hair/scalp care or baby massage. Qualitative research indicates that parents and health professionals believe that water alone is best.
KEY CONCLUSIONS
meta-analysis was restricted due to the lack of consistency of study outcome measures. Although there is considerable RCT evidence comparing the use of specific products against water alone, or another product, for bathing, cleansing and nappy care, the power of this evidence is reduced due to inconsistency of outcome measures in terms of outcome, treatment site or time-point. The development of a core outcome measure set is advocated for trials assessing skin care practices.
IMPLICATIONS FOR PRACTICE
this review offers health professionals best evidence available on which to base their advice. Of those studies with comparative outcomes, the evidence indicates no difference between the specific products tested and water alone; offering parents a choice in their baby skin care regimen. Protocol available: http://www.crd.york.ac.uk/PROSPEROFILES/28054_PROTOCOL_20151009.pdf.
Topics: Baths; Female; Hair; Humans; Infant; Infant Care; Infant, Newborn; Outcome Assessment, Health Care; Pregnancy; Skin Care
PubMed: 29055852
DOI: 10.1016/j.midw.2017.10.001 -
Skin Pharmacology and Physiology 2023Skin care is a basic, daily activity performed by formal and informal caregivers from birth until end of life. Skin care activities are influenced by different factors,... (Review)
Review
BACKGROUND
Skin care is a basic, daily activity performed by formal and informal caregivers from birth until end of life. Skin care activities are influenced by different factors, e.g., culture, knowledge, industrial developments and marketing activities. Therefore, various preferences, traditions, and behaviors exist worldwide including skin care of neonates and infants. The objective of this scoping review was to obtain an overview about the evidence of skin care activities in neonates and infants. Studies from 2010 were eligible if the population was (skin) healthy neonates and infants; if the concept was skin care interventions; and if the context was at home, in a community setting, in a pediatric outpatient service, or in a hospital. We searched for the literature via OVID in MEDLINE and Embase, in the Cochrane Library, in trial registries and for gray literature.
SUMMARY
We identified 42 studies since 2010, which examined four main skin care interventions: bathing, wiping, washing, and topical application of leave-on products. Details of interventions were often not reported, and if they were, they were not comparable. The four skin care interventions focused on 13 different care goals, mainly prevention of skin diseases, maintaining skin barrier function, and improving (skin) health. We evaluated effects of skin care interventions using 57 different outcome domains; 39 of 57 were skin-related and 18 were not. Mostly, laboratory or instrumental measurements were used.
KEY MESSAGES
Our scoping review identified four skin care interventions with a broad heterogeneity of product categories and application details. Studies in skin care interventions should include all relevant information about product category and application details to ensure comparability of study results. This would be helpful in developing recommendations for formal and informal caregivers. We identified 13 skin care goals. "Maintaining healthy skin/skin barrier function/skin barrier integrity," "prevention of atopic dermatitis," "cleansing," and "improving skin barrier function" were most often allocated to skin care interventions. There is substantial variability regarding outcome domains in skin care research. Our results support the need of developing core outcome sets in the field of skin care in healthy skin, especially in this age-group of neonates and infants.
Topics: Infant, Newborn; Humans; Infant; Child; Skin Care; Skin
PubMed: 36750047
DOI: 10.1159/000529550 -
Journal of Perinatology : Official... Jun 2017Skin provides several important homeostatic functions to the developing neonate. However, no consensus guidelines exist in the United States for skin care in the healthy... (Review)
Review
OBJECTIVE
Skin provides several important homeostatic functions to the developing neonate. However, no consensus guidelines exist in the United States for skin care in the healthy term newborn.
STUDY DESIGN
We performed a study of skin and umbilical cord care (including bathing practices, vernix removal and antiseptic cord application) in newborn nurseries and mother-baby units throughout the state of Maryland to determine practices in a variety of clinical settings and assess if uniformity in skin care exists. These data were then assessed in the context of a review of the current literature.
RESULTS
We received responses from over 90% of nurseries across the state. In our cohort, practices varied widely between institutions and specific populations, and often were not evidence-based or were contrary to best practices discussed in the scientific literature.
CONCLUSION
The frequent departures from evidence that occur regarding the aforementioned practices are likely due to a lack of consensus on these issues as well as limited data on such practices, further highlighting the need for data-driven guidelines on newborn skin care.
Topics: Anti-Infective Agents, Local; Humans; Infant Care; Infant, Newborn; Maryland; Nurseries, Hospital; Practice Guidelines as Topic; Skin Care; Umbilical Cord
PubMed: 28005064
DOI: 10.1038/jp.2016.226 -
International Journal of Dermatology Jan 2013Skin care practices play an important role in the health of well newborns and hospitalized neonates. Fortunately, for many aspects of neonatal skin care, there exist... (Review)
Review
Skin care practices play an important role in the health of well newborns and hospitalized neonates. Fortunately, for many aspects of neonatal skin care, there exist evidence- or consensus-based recommendations to guide best practices. Based on our review of the recent medical literature, we include in this manuscript the current recommendations regarding neonatal skin cleansing and antisepsis; umbilical cord care; use of emollients; and prevention of diaper dermatitis. In addition, we review the recommended practices for preventing and treating pressure ulcers, wounds, and other skin injuries in hospitalized neonates.
Topics: Dermatitis; Dermatologic Agents; Diaper Rash; Evidence-Based Practice; Humans; Infant, Newborn; Practice Guidelines as Topic; Skin Care; Umbilical Cord
PubMed: 23278604
DOI: 10.1111/j.1365-4632.2012.05687.x -
Zeitschrift Fur Gerontologie Und... Jun 2015Aged skin is the sum of chronological und UV-induced aging. Light-exposed skin is unattractive, with irregular pigmentation, roughness und scaliness. The skin is often... (Review)
Review
BACKGROUND
Aged skin is the sum of chronological und UV-induced aging. Light-exposed skin is unattractive, with irregular pigmentation, roughness und scaliness. The skin is often dry and itches.
METHODS
The present paper provides an overview of diseases of aging skin and describes how to prevent or reduce disease by prophylactic and therapeutic skin care.
RESULTS
Aged skin can develop into several skin diseases, e.g., different types of eczema and skin cancer. In the body folds we often find an irritant contact eczema caused by friction from skin to skin, sweating, and urinary and fecal incontinence. In the bedridden, bed sores can also develop. Furthermore, there is a delay in wound healing owing to old age. Use of adequate creams and ointments is very helpful in preventing and improving most skin diseases of mature skin. However, the knowledge of aged people and healthcare professionals about the importance of skin care is low. Older people are often unable to care for their skin because they are lacking the physical and mental ability.
CONCLUSION
Healthcare professionals are not sufficiently trained about the value of proper skin care. Adequate studies on the role of skin care and selection of the correct preparation in various aged-related diseases are lacking.
Topics: Aged; Humans; Ointments; Photosensitivity Disorders; Skin Aging; Skin Care; Skin Cream
PubMed: 25117860
DOI: 10.1007/s00391-014-0670-5 -
Pediatric Dermatology 2012In recent years, there have been continuing efforts to understand the effects of baby skin care routines and products on the healthy development of baby skin. Such... (Review)
Review
In recent years, there have been continuing efforts to understand the effects of baby skin care routines and products on the healthy development of baby skin. Such efforts aim ultimately to determine the best infant skin care practices. The pediatric and dermatologic communities have not reached consensus on what constitutes an appropriate cleansing practice. In the United States, guidelines for neonatal skin care have been developed, propagated, and implemented. The accumulated knowledge has promoted evidence-based clinical practices and, therefore, may help to improve clinical outcomes, although these guidelines primarily cover the care of preterm newborns and the treatment of those with other health problems. High-level, long-term clinical evidence of the effective and safe cleansing of healthy, full-term newborns and infants is scarce. This review presents a comprehensive analysis of the scientific literature on baby skin development, cleansing practices, and related products (for healthy newborns and babies) since 1970. The evidence drawn from the reviewed literature can be summarized as follows: Bathing immersed in water seems generally superior to washing alone. Bathing or washing with synthetic detergents (syndets) or mild liquid baby cleansers seems comparable with or even superior to water alone. Nevertheless, larger randomized clinical trials with age-defined cohorts of babies as well as more-defined parameters are required to identify optimal practices and products for skin cleansing of healthy infants. These parameters may include standardized skin function parameters such as transepidermal water loss, stratum corneum hydration, skin surface pH, and sebum production. Clinical skin scores such as the Neonatal Skin Condition Score may be employed as outcome measures.
Topics: Dermatitis; Evidence-Based Practice; Humans; Hygiene; Infant; Infant, Newborn; Practice Guidelines as Topic; Skin Care
PubMed: 22011065
DOI: 10.1111/j.1525-1470.2011.01594.x -
Neonatal Network : NN Jun 1999To review the literature addressing the care of neonatal skin. (Review)
Review
OBJECTIVE
To review the literature addressing the care of neonatal skin.
DATA SOURCES
Computerized searches in MEDLINE and CINAHL, as well as references cited in articles reviewed. Key concepts in the searches included neonatal skin differences; neonatal skin and care practices for skin integrity; neonatal skin and toxicity; permeability; and contact irritant sensitization.
STUDY SELECTION
Articles and comprehensive works relevant to key concepts and published after 1963, with an emphasis on new findings from 1993 to 1999. One hundred two citations were identified as useful to this review.
DATA EXTRACTION
Data were extracted and organized under the following headings: anatomy and physiology of the skin; physiologic and anatomic differences in neonatal skin; nutritional deficiencies; skin care practices; and care of skin breakdown.
DATA SYNTHESIS
Newborns' skin is at risk for disruption of normal barrier function because of trauma. In light of available evidence about differences in neonatal skin development, clinical practice guidelines are suggested for baths, lubrication, antimicrobial skin disinfection, and adhesive removal. In addition, basic care practices are suggested for maintaining skin integrity, reducing exposure to potentially toxic substances, and promoting skin health beyond the neonatal period. Preventive care recommendations are made for reducing trauma, protecting the skin's immature barrier function, and promoting skin integrity.
CONCLUSIONS
This review generated evidence with which to create a new and comprehensive practice guideline for clinicians. Evaluation of the guideline is under way at 58 U.S. sites.
Topics: Baths; Evidence-Based Medicine; Humans; Infant, Newborn; Neonatal Nursing; Practice Guidelines as Topic; Skin Care; Skin Physiological Phenomena
PubMed: 10633681
DOI: 10.1891/0730-0832.18.4.15 -
Dermatologic Clinics Jul 1998Infant skin differs from adult skin in several ways. These important differences place infants at increased risk for fluid electrolyte imbalance, thermal instability,... (Review)
Review
Infant skin differs from adult skin in several ways. These important differences place infants at increased risk for fluid electrolyte imbalance, thermal instability, skin damage, percutaneous infection, and percutaneous toxicity from topically applied agents. This article includes a review of skin development, as well as the details of current skin care practices in the neonatal nursery. A better understanding of the principles of infant skin care and a more uniform approach to skin care in the neonatal nursery can minimize risks and costs to this special population of patients.
Topics: Humans; Infant, Newborn; Skin Care; Skin Physiological Phenomena
PubMed: 9704203
DOI: 10.1016/s0733-8635(05)70244-8 -
Ostomy/wound Management Sep 1997The Agency for Health Care Policy and Research (AHCPR) identified the need to develop clinical practice guidelines for the prevention and treatment of pressure ulcers, a... (Review)
Review
The Agency for Health Care Policy and Research (AHCPR) identified the need to develop clinical practice guidelines for the prevention and treatment of pressure ulcers, a segment of wound and skin diagnoses. The skin is the first line of defense in protecting the body from constant changes in the environment. Far too often, the attention needed for the skin is only realized after the integrity has been disrupted. This article examines the anatomy and physiology of the skin, factors that affect the skin (aging, bathing, cleansers, dryness, friction, lotions, moisturizers, nutrition, soaps and shearing forces), indications and contraindications of topical skin care products, and AHCPR's recommended interventions. These elements are integral to clinicians in proactively developing sound skin care prevention strategies. Yet without a thorough understanding of all components, the skin's integrity remains at risk.
Topics: Humans; Risk Factors; Skin; Skin Care; Skin Physiological Phenomena
PubMed: 9385177
DOI: No ID Found