Skin Care Products for Pressure Ulcer Prevention

A man sleeping in a hospital bed

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Each year, an estimated 60,000 U.S. hospital patients die from complications due to hospital-acquired pressure ulcers, sometimes referred to as "bed sores." Several studies from nursing journals, wound care journals, and even the New England Journal of Medicine have all concluded a similar prevalence. Almost 3 million patients are treated in acute care hospitals for pressure ulcers every year.

Costs to the U.S. Health Care System

Most estimates set the cost of this single hospital-acquired condition at $11 billion annually. Depending on how the various studies slice the cost data, the cost to treat a pressure ulcer in a single patient ranges from as low as $10,000 to $125,000 per patient.

The Centers for Medicare and Medicaid Services (CMS) believe almost 260,000 pressure ulcers per year are preventable. That means large numbers of patients admitted to hospitals for one condition develop a pressure ulcer during their stay. As a result, the Deficit Reduction Act of 2005 and the CMS' Inpatient Prospective Payment System (IPPS) Fiscal Year 2009 Final Rule have made hospital-acquired pressure ulcers a big target for reducing wasteful cost.

Medical Supplies That Aid In Pressure Ulcer Prevention

Manufacturers have developed several products that have proven effective in reducing the incidence of hospital-acquired pressure ulcers, as well as treating the high-risk conditions that can often lead to them. The most common types of products include skin-care creams, lotions, cleansers, and powders; absorbent dry pads; specialized adult briefs and pressure redistribution mattresses and pads. In the Operating Room, surgical teams can use absorbent table pads, sheets, and gel positioners.

Skin Repair Applications

There are now gentle solutions for most skin issues. New solutions on the market avoid the use of harsh soaps and detergents but are still able to lift the dirt and oils from the skin. Thus, the already compromised skin is not damaged any further. The products on the market should be pH balanced, non-cytotoxic, non-sensitizing, non-irritating and non-allergenic.

Another key feature to consider is a moisture barrier. Skin protectants that contain silicones powerful enough to help prevent excessive transepidermal water loss (e-TEWL). Unlike petroleum-derived products, these will not interfere with the skin's natural ability to breath. In addition, some of these products include zinc oxide to help protect the skin from moisture, incontinence, perspiration and wound exudate.

Types of Cleansing and Barrier Solutions and Creams

  • No-rinse cleansing body lotions moisturize and provide light protection from incontinence. Used for the cleansing of the face, body, perineal, and peristomal areas.
  • Foaming body cleansers are typically no-rinse foams for head-to-toe cleansing and conditioning. Used to clean the hair, face, body, perineal and peristomal areas.
  • Antimicrobial cleaners are no-rinse cleansers that inhibit bacterial growth. These, too, can be used for head-to-toe cleansing and conditioning.
  • Skin repair cream helps restore the skin's natural moisture balance. Skin repair creams can be used by all patients, including those who are at high risk for skin breakdown.
  • Skin protectants are moisturizers that also provide a light moisture barrier. These skin protectants are typically indicated to help relieve discomfort associated with light incontinence or diaper rash. Perfect for irritated (but not broken) skin.
  • Silicone-based skin protectants are creams that provide substantial skin protection against excessive transepidermal water loss (e-TEWL). Best for skin conditions associated with diaper rash caused by wetness, urine and/or stool. The silicone barrier can usually last for up to three to five washings and remains semi-permeable and non-occlusive (does not block the skin's ability to breathe).
  • Skin protectant pastes are considered ideal for normal to broken-down skin and peristomal areas. These thick pastes provide a barrier for the skin against moisture, and some include zinc oxide that helps with itching and minor irritation. Other ingredients in the paste can cool and soothe inflamed skin, while others help with minor absorption of exudate (fluid from inflammation) from broken skin.
  • Clear skin protectants provide a protective moisture barrier that adheres to wet, macerated skin and allows for easy monitoring of the skin underneath it. This type of protectant is recommended for use in the perineal area and lower extremities to protect against minor skin irritation and dryness. It is an invisible ointment that shields the skin against excessive moisture from incontinence or wound drainage. Some of these protectant products have the ability to wick excess moisture away from the skin.
  • Antifungal creams and powders help treat fungal infections while delivering nutrients to the skin. Antifungals help relieve burning, irritation, and itching.
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