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Evidence-Based Skin Care

A Systematic Literature Review and the Development of a Basic Skin Care Algorithm

Lichterfeld, Andrea; Hauss, Armin; Surber, Christian; Peters, Tina; Blume-Peytavi, Ulrike; Kottner, Jan

Journal of Wound Ostomy & Continence Nursing: September/October 2015 - Volume 42 - Issue 5 - p 501–524
doi: 10.1097/WON.0000000000000162
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Patients in acute and long-term care settings receive daily routine skin care, including washing, bathing, and showering, often followed by application of lotions, creams, and/or ointments. These personal hygiene and skin care activities are integral parts of nursing practice, but little is known about their benefits or clinical efficacy. The aim of this article was to summarize the empirical evidence supporting basic skin care procedures and interventions and to develop a clinical algorithm for basic skin care. Electronic databases MEDLINE, EMBASE, and CINAHL were searched and afterward a forward search was conducted using Scopus and Web of Science. In order to evaluate a broad range of basic skin care interventions systematic reviews, intervention studies, and guidelines, consensus statements and best practice standards also were included in the analysis. One hundred twenty-one articles were read in full text; 41documents were included in this report about skin care for prevention of dry skin, prevention of incontinence-associated dermatitis and prevention of skin injuries. The methodological quality of the included publications was variable. Review results and expert input were used to create a clinical algorithm for basic skin care. A 2-step approach is proposed including general and special skin care. Interventions focus primarily on skin that is either too dry or too moist. The target groups for the algorithm are adult patients or residents with intact or preclinical damaged skin in care settings. The goal of the skin care algorithm is a first attempt to provide guidance for practitioners to improve basic skin care in clinical settings in order to maintain or increase skin health.

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Andrea Lichterfeld, MA, Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité–Universitätsmedizin, Berlin, Germany.

Armin Hauss, MSc, Clinical Quality and Risk Management, Charité - Universitätsmedizin Berlin, Germany

Christian Surber, PhD, Department of Dermatology, University of Basel and Zurich, Switzerland.

Tina Peters, MSc, Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité–Universitätsmedizin Berlin, Germany.

Ulrike Blume-Peytavi, MD, PhD, Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité–Universitätsmedizin Berlin, Germany.

Jan Kottner, PhD, Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité–Universitätsmedizin Berlin, Germany.

Correspondence: Andrea Lichterfeld, MA, Charité–Universitätsmedizin Berlin, Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117, Berlin, Germany (andrea.lichterfeld@charite.de).

The authors declare no conflicts of interest.

© 2015 by the Wound, Ostomy and Continence Nurses Society.