improving neonatal skin care- emory departmentof pediatrics（改善新生儿皮肤护理-埃默里departmentof儿科）.doc

Improving Neonatal Skin Care Gayla Eppinger, NNP-BC Emory University Atlanta GA Improving Neonatal Skin Care Learning Objectives Describe the structure and function of neonatal skin Explain and apply the Neonatal Skin Condition Scale Identify clinical practice goals related to neonatal skin care Describe recommended skin care practices Understand new evidence-based research and recommendations Function of the Skin Serves as barrier against infection and protects internal organs Plays major role in thermoregulation and storage of fat Regulates insensible water loss, also secretes electrolytes water Provides tactile sensory input and sensations of touch, pressure, temperature, pain itch Difference in Neonatal Skin Skin of the premature neonate accounts for 13% of their body weight as compared to 3% of the body weight of an adult Premature neonate has body surface/weight ratio ~ five times greater than that of an adult The skin of a premature neonate is 40-60% thinner than adult skin Anatomy of the Skin Epidermis: functions as a barrier, preventing penetration and absorption of potential toxins and microorganisms, as well as retaining heat and water. Stratum Corneum: outermost layer of cells forming the epidermis. Non-living layer made up of dead cells constructed like a wall of bricks and mortar Forms part of the vernix caseosa, controls transepidermal water loss (TEWL), prevents absorption of toxic substances Difference in Neonatal Skin 10-20 layers of stratum corneum in full-term infants and adults Neonate 30 weeks gestation has only 2-3 layers and at 23-24 weeks virtually no stratum corneum Maturation rate of stratum corneum varies based on the gestation age: At 27 weeks the process is slowed; At 23-25 weeks it takes 8-10 weeks to develop the function of full term skin; At 27 weeks approaches full-term skin function by ~10 days postnatal age Risks of underdeveloped Stratum Corneum Infections and skin irritation Increase in insensi