Cuidados de la piel del bebé prematuro

Abstract

Objective: to update the knowledge on cutaneous anatomical physiology in preterm newborns, and the most adequate nursing care that must be conducted in order to maintain the integrity of this first line of defence. Method: a bibliographical search over the past 10 years (2007-2017) including reviews and original articles in English, Spanish, Portuguese and French. The databases consulted were: LILACS, MEDLINE/PubMed, Bibliosaúde and Google Scholar. MeSH and DeCS terms were used, in combination with Boolean operators. Results: there was a final selection of 59 articles: 33 bibliographic reviews and 22 original articles. The main lesions were nappy rash, thermal and chemical burns, skin tears, extravasation injuries, bruises and pressure ulcers. At a lower gestational age, there is a higher risk of developing skin lesions, mainly due to the limitation in spontaneous mobility and exposure to humidity. Chlorhexidine causes burns and erythema; the use of non-alcoholic antiseptic agents is recommended. Daily baths and use of soap must be avoided, because they will alter the skin pH and prevent the formation of the acid coating. The use of emollient agents and the umbilical cord care are controversial. Conclusions: the main subjects studied were bath habits, umbilical cord care, nappy rash, pressure ulcers, and the use of adhesive, emollient and antiseptic agents. The outcomes reached were controversial in terms of the adequate skin care. Additional experimental studies are required, in order to standardize patient care.