Prevention of Damage and
Management of Frail, At-Risk Skin

* Patients at risk for skin injury include: the elderly, those with dermatological conditions, patients on long-term steroid medications, patients with acute, severe illness or following surgical procedures, long-term chronic illness, patients with malnutrition, dehydration and vitamin deficiency.

* Keep its skin clean and dry. Bathe the patient with a pH balanced cleanser or mild soap and water. Apply a moisturizer to skin after bathing to keep the epidermis soft and supple.

* Minimize potential for skin damage secondary to adhesive tape and dressing use. When adhesive products are required:
- Use porous tapes whenever possible.
- Clip hair prior to application of tape or barrier film.
- Clean and dry skin before adhesive application.
- Apply and alcohol free barrier film to protect skin from adhesive damage.
- Apply tape without attention and smooth gently from the center out.
- To remove, loosen ends of the tape strips or edges of the dressings. Gently peel back, supporting the skin immediately adjacent to the product being removed. Keep the adhesive tape or dressing close to surface as you pull it back. A gentle adhesive remover may also be used to assist in removal.
- Remove tape and dressings in the direction of hair growth.
- Use a cohesive rap as an adhesive alternative to secure dressings or tubing on extremities (if skin is at high-risk for adhesive injury).

* Minimize potential for skin damage from exposure to urine and feces.

* Minimize potential for damage resulting from mechanical forces such as friction, sheer and pressure.
- Minimize layers of bedding; keep bedding free of wrinkles.
- Use a support surface if patient is at risk for pressure ulcer development.