What is the evidence on skin care for maintaining skin integrity and prevention of wounds? An integrative review

Abstract

Aim To synthesise evidence regarding skin care to maintain skin integrity and prevent wounds. Methods An electronic search of key terms (skin care or skin integrity) was undertaken of articles published between 1 January 2018 until 30 September 2023. A narrative integrative review synthesised results. Results In all 73 articles met the inclusion criteria. The topics included cleansers, moisturisers, and/or barrier products (n=33), health service interventions related to skin care (n=15), and the impact of dressings on skin integrity (n=12). Eight encompassed multiple interventions, three examined self-management and two foot skin care. Conclusion Strong evidence on skin management to prevent wounds is limited. Moderate evidence supported the use of mild, non-alkaline cleansers and low pH moisturisers with humectants to improve skin integrity and prevent skin tears; in addition to prompt cleansing, use of topical barrier leave-on products and absorbent products to prevent incontinence-associated dermatitis. The choice of prophylactic dressing is not a one-size-fits-all decision but rather a nuanced clinical decision that must consider the specific needs and circumstances of each patient. Use of person-centred care, evidence-based interventions by healthcare providers, and involvement of the interprofessional teams emerged as central themes of skin care for prevention of wounds.