Effects of critical patient-centred skin care on barrier functions of skin

Objective: This study aimed to examine the effects of critical patient-centered skin care on skin barrier functions, pressure injury incidence, and pressure injury risk scores. Method: This randomized controlled trial study was conducted in the tertiary intensive care unit of a state hospital between September 2023 and February 2024. It involved 43 critical care patients, with 22 in the experimental group and 21 in the control group. Data were collected using a sociodemographic and clinical characteristics form prepared by the researchers, and the Jackson/Cubbin risk scale. Critical Patient-Centred Skin Care was applied to patients in the experimental group while routine clinical skin care was applied to patients in the control group. The interventions began upon patient admission to the intensive care unit, and each patient was followed for 4 days. Transepidermal water loss and skin acidity were measured from the sacral region and trochanters of all patients during the follow-up. Pressure injuries were staged according to the system published by the European Pressure Ulcer Advisory Panel in 2019. Results: The socio-demographic and clinical characteristics of the experimental and control groups were similar (p>0.05). On the first day of the interventions, the mean sacral transepidermal water loss (TEWL) was 29.62±13.04 in the experimental group and 21.01±8.95 in the control group (p<0.05). By the last day, the mean TEWL was significantly lower in the experimental group compared to the control group (p<0.05). The mean TEWL of the sacral region in the experimental group decreased over the follow-up period, while it increased in the control group (p<0.05). Evidence-based, person-centered practices in the experimental group showed a statistically significant difference in frequency (p<0.05). The mean skin acidity values of both groups were similar (p>0.05). On the 4th day, the Jackson Cubbin risk score were higher in the experimental group compared to the control group (p<0.001). The incidence of pressure sores was higher in the control group p<0.05) Conclusion: Patient-centered skin care practices in critical care units may be an effective nursing intervention for maintaining skin barrier functions and preventing pressure injuries.