Abstract
to describe the main evidence available in the literature on safe practices in the prevention and care of skin lesions in newborns admitted to Neonatal Intensive Care Units. integrative literature review in the PubMed, BDENF, LILACS, MEDLINE, SciELO and Cochrane Library databases between 2013 and 2018. We included primary articles on: lesion prevention and skin care in newborns in Portuguese, English or Spanish and excluded editorials, thesis, dissertations and duplicate articles. For the evidence level, we used the Melnyk and Fineout-Overholt classification, which classifies studies between weak to strong evidence. a total of 10 articles with moderate to weak evidence on thermoregulation, bathing, lesion prevention, use of patches and skin antisepsis. there was a shortage of publications with high evidence, and it is necessary to invest in research that seeks to support safer skin care practices.
Highlights
The newborn’s (NB) epidermal barrier begins to form in the womb and its histological development is complete at 34 weeks of gestation
The stratum corneum of newborn children resembles that of adults, while in the preterm newborn (PTN) there are few layers of stratum corneum and the cells are thinner(1)
Based on the above considerations, this study suggests the need to rethink patient safety in the Neonatal Intensive Care Units (NICU), with a view to reducing health care-related damage and adverse events and an emphasis on ensuring skin integrity
Summary
The newborn’s (NB) epidermal barrier begins to form in the womb and its histological development is complete at 34 weeks of gestation. The stratum corneum of newborn children resembles that of adults, while in the preterm newborn (PTN) there are few layers of stratum corneum and the cells are thinner(1) Both full-term and preterm infants offer greater predisposition to skin lesions due to increased permeability, which causes greater water loss, electrolyte and temperature disturbances, and greater exposure to environmental irritants and infectious agents(1). Linked to these factors, hospitalization in Neonatal Intensive Care Units (NICU) is a highly complex care scenario, which involves high risk to the patient due to the physiological and hemodynamic instability of the newborn and the characteristics and diversity of procedures performed, which requires continuous patient monitoring to avoid breach of care safety(2-3). The daily routine of care in the NICU subjects the newborn to risk for skin integrity rupture many times, from simple interventions such as manipulation and positioning, bathing, fixation, removal of tapes and devices, to performing invasive procedures such as venous and arterial punctures(4)
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