Global Variation in Skin Injuries & Care for Extremely Preterm Infants

Global Variation in Skin Injuries & Care for Extremely Preterm Infants 👶🌍

Extremely preterm infants (born <28 weeks) face unique vulnerabilities: fragile skin, high risk of fluid loss, infections, and injury. To understand global practices, a survey across 848 NICUs worldwide revealed critical insights:
🔹 Key Findings:
✅Skin injuries are common: diaper dermatitis (39%), medical adhesive injuries (38%), perineal injuries (26%), abrasions (24%), and pressure injuries (22%).
✅Significant regional differences: North America reported the highest diaper dermatitis rates; Asia and South America showed elevated adhesive-related injuries.
✅Local guidelines matter: NICUs with skincare protocols saw up to 59% fewer infections and 37% fewer adhesive injuries.
✅Frequent skin assessments (every 4 hours) reduced abrasions, pressure injuries, and dermatitis significantly.
✅Adhesive practices and emollient use varied widely; oil-based emollients showed protective effects, while petrolatum-based products were linked to higher complications.

Antisepsis practices differed globally, with concerns about iodine and alcohol absorption in extremely preterm infants.
📌 Takeaway: Consistent local guidelines, frequent surveillance, and evidence-based product choices are key to reducing skin injuries in this vulnerable population. Future research must refine region-specific protocols to close practice gaps.