Challenges of Maintaining Skin Integrity in Neonatal and Paediatric Patients

Whilst there is a lot of focus on pressure ulcer prevention and treatment in adults, there are limited products available that have been tailored specifically for paediatric and neonatal patients, with few manufacturers acknowledging the clinical challenges around maintaining skin integrity in this vulnerable group of patients.

Neonatal and paediatric patients are at a very high risk of pressure damage due to the vulnerability of their skin. In circumstances when a neonate is critically unwell, maintaining the viability of their skin may not be the main priority.

Additional challenges include:

Decreased mobilisation

When a neonate or paediatric patient is critically ill, their natural movements may be compromised due to required use of sedation and paralysing agents. Frequent turning regimes may be contraindicated in unstable, critically ill patients, especially those receiving ECMO. This increases the risk of skin damage as the child is exposed to prolonged periods of pressure due to non-movement.

Vulnerable occiput

In children younger than 36 months, the head is marginally disproportionate to the rest of the body. This means the head has a greater proportion of the body weight, resulting in it being the main pressure point when the neonate is laying supine.

Inappropriate products

Many products available for adult pressure ulcer prevention and treatment have a minimum weight that is too high for paediatric and neonatal patients. Many also have specific zones that a patient must lie on to achieve the optimum clinical performance. These ‘zones’ are often based on an adult profile whereas neonates and paediatrics have smaller torsos, meaning that often they are not able to be positioned in this zone, resulting in ineffective therapy. In addition, neonates and paediatrics have extremely friable skin and can mark easily if they are on a surface that is too hard or inappropriate for their low weight.

Medstrom are one of the few suppliers that can offer a tailored range of paediatric and neonatal surfaces including Dolphin Therapy paediatric, Neo and Optima Juve.

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