Innovations in Pediatric Care: Theory into Practice

            Pediatric patients present interesting challenges for both the health care providers and family member when trying to maintain skin integrity. One area of challenge is maintaining skin integrity around tube sites, ties, casts and under neck folds. 

            Moisture maceration under g-tubes, penrose drains, tracheostomy ties and neck folds threaten to break down skin in both the hospital and the outpatient setting. Parents are responsible for taking care of children with these various drains and can be extremely challenged when the skin breaks down.  There is pain, disfigurement and prolonged healing times when the skin does break down.

            When the current standards of practice fail, the health care provider and the parent seek new alternatives to prevent both the enzymatic and non-enzymatic drainage from breaking down the skin.  However there are limited documented alternatives.  A theoretical alternative is the moisture wicking fabric. In theory the fabric will wick away moisture from the source and out to the atmosphere. This theoretical idea was put to the challenge in the pediatric setting.

            Over the course of a year the fabric was used in seven different situations in pediatric patients who experienced skin breakdown due to moisture. Each patient was given a 24-hour trial and reassessed. The method of use was then repeated in similar cases.

            The results were the fabric is user friendly. It can be used around g-tubes and Penrose drains, under tracheostomy ties, and in skin folds. The fabric can also be used over central line dressings that are in a skin folds to maintain the integrity of the dressing. The limitations of the fabric were also understood.