Effects of patient-centred skin care on barrier functions of skin in intensive care

Yeni, Tuğba, Enç, Nuray and Worsley, Peter R. (2025) Effects of patient-centred skin care on barrier functions of skin in intensive care. Journal of Wound Care, 34 (9), 689-690. (doi:10.12968/jowc.2025.0369).

Abstract

Introduction: in recent years, studies have been conducted to better understand the pathophysiology of pressure injuries (PIs), demonstrating the importance of skin barrier properties, stratum corneum hydration and skin pH during the early signs of skin damage.1,2,3 Addressing factors affecting the pathophysiology of a PI can improve the quality of nursing care. However, studies investigating the results of patient-centred care in preventing PIs are limited in the literature.4,5 The aim of this study was to investigate the effects of patient-centred skin care on local skin properties and the incidence of PIs.

Method: this randomised controlled trial was conducted in the tertiary intensive care unit (ICU) of a state hospital. Patients were divided into either the intervention group, which received patient-centred skin care, or the control group, which received standard skin care. The intervention began upon patient admission to the ICU, and each patient was followed for four days. Data were collected using a sociodemographic and clinical characteristics form, the Jackson/Cubbin risk scale and skin monitoring form.6 Transepidermal water loss (TEWL) and skin acidity were measured from the sacrum and trochanters during follow-up. Data analysis was performed using IBM SPSS Statistics 29.0 (IBM Corp., US). A one-way analysis of variance (ANOVA) was used for variables with normal distribution and Wilcoxon Sign Rank tests were used for variables without normal distribution for repeated measurements.

Results: there were no differences in the sociodemographic and clinical characteristics of the patients assigned to the intervention (n=22) and control groups (n=21) (p>0.05). TEWL values tended to decrease in the intervention group. On the fourth follow-up day, the value of sacral TEWL of the intervention group was 21.2±7.9, while the value of sacral TEWL of the control group was 28.1±10.3, which was a statistically significant difference (p<0.05). The skin acidity values of both groups were similar (p>0.05). While the incidence of PI was 38.1% in the control group, it was 9.1% in the intervention group (p<0.05).

Conclusion: the findings of this trial showed that patient-centred skin care was an important nursing intervention in maintaining skin and tissue integrity, as well as the barrier function of skin. However, there are many factors that affect the barrier function of the skin in ICUs. It is recommended that future studies be conducted with larger populations and longer follow-up to understand changes in biophysical parameters and the effects of patient-centred care.

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