Wound Care in the Neonatal Intensive Care Unit

Abstract

The skin is a vital organ with key protective functions. Infants in the NICU are at risk for skin injury because of developmental immaturity and intensive care treatments. When skin injury occurs, the neonatal nurse is challenged to provide wound care to optimize functional and cosmetic healing. Optimal wound care requires basic knowledge of the mechanisms of injury, physiology of wound healing, host factors affecting wound healing, and wound assessment. This knowledge provides the basis for determining appropriate wound treatment, including dressing selection. Attention to pain issues associated with wound care is difficult because of the infant's developmental stage, but is essential because of the potentially negative life-long impact of pain. The premature infant's propensity for skin stripping limits the selection of appropriate dressing, as does the paucity of research examining wound care products in this population.

Treatment of skin lesions in newborn children: meeting the needs of nursing staff

“…The choice of the product depends on the type of tissue that lies on the bed of the lesion, the depth of the lesion, the amount of exudates, and the presence of signs of local infection (5) . It is necessary to select a product that provides an adequate environment for healing by maintaining adequate moisture.…”

“…Only one study was found (5) regarding the effectiveness of the use of this product in newborn children and there is no evidence to ensure the absence of longterm risks in using this type of dressing.…”

“…Babies with less than 34 weeks gestational age (GA) have thinner and more immature strata cornea, which allows water to pass from the inside to the outside of the body, and substances applied to the skin are potentially absorbed, which can cause toxicity (5,11) .…”

“…They should also know about the assessment and the treatment of lesions, based on the best evidence to restore function and appearance with a minimum of complications (5) .…”

“…In order to provide correct treatment, nurses should eliminate or control the causative factors and provide a favorable environment for healing (4)(5) .…”