Successful Management of Moisture-, Friction-, and Trauma-associated Skin Damage in the Pediatric and Neonatal Population Using Cyanoacrylate Skin Protectant

Abstract

Moisture-associated skin damage occurs in 4% to 37% of the pediatric population. Commonly described treatments can be challenging to apply to small neonatal wounds, and concerns exist about absorption, cutaneous side effects, and use in certain populations (eg, preterm neonates). This single-center, retrospective case series evaluated the use of cyanoacrylate liquid skin protectant (CSP) to manage moisture-, friction-, and trauma-associated pediatric and neonatal wounds. Fifteen pediatric and neonatal patients with wounds of various etiologies were treated with 1 to 3 applications of CSP. The product is a purple-colored liquid that comes in a small-sized and large-sized applicator and immediately adheres to the skin, taking approximately 1 minute to dry. One to 2 coats were applied to the affected area. Subsequent applications were prescribed as needed, depending on the skin condition. Before CSP application, some patients underwent different treatments deemed necessary by the treating practitioners. There were 7 neonate patients (age range, 4 days-3 weeks), with a gestational age of 25 weeks to full term. Wounds included incontinence-associated dermatitis; peristomal, gastrostomy-associated, and tracheostomy-associated dermatitis; and skin tears. In the 8 older patients (age, 1-5 months; 10 years; 12 years; 16 years), wounds included gastrostomy and tracheostomy-associated dermatitis and granulation tissue, epidermal stripping from adhesive dressing removal, intertriginous dermatitis, and lesions resulting from graft-versus-host disease. Application of CSP facilitated the healing of dermatitis and peristomal excoriations as well as facilitated skin dryness, leading to increased wear time of a peristomal appliance. Peristomal dryness contributed to less friction and likely was the reason for granulation tissue recession. Cyanoacrylate liquid skin protectant can be considered in the management of pediatric moisture- and friction-associated cutaneous injuries, skin tears, and exudative wounds. It can be used as a stand-alone therapy or in combination with standard of care.