Skin Prep- waste of time?

[anonymous1919, LPN]

How do skin preps help heels? I have like 10 patients who need skin preps on their heels bid... it is very time consuming to take their shoes and socks off, wipe it on their heels, and put their shoes and socks back on. Does it really help prevent break down? And how?

According to this site: Smith & Nephew - Skin-Prep*

this is what they're for:

Upon application to intact skin, Skin-Prep* protective wipes forms a protective film that prepares the skin for the attachment of drainage tubes, external catheters, adhesive dressings and can be used around ostomy sites.

So why am I putting skin prep on their heels? I'm not taping their heels or taking tape off lol

[ErinS, BSN, RN]

I would not think skin prep would be terribly helpful, but a conditioning ointment may be helpful. I would also think floating everyone's heels would also be more helpful than skin prep.

[cherrybreeze, ADN, RN]

I've never heard of doing that, so I guess I'm not much help...

[GHGoonette, BSN, RN]

No, I don't see the point of that either!. The only thing I know (but I've been out of the field of LTC a LOOOOONG time!) is that the only "effective" treatment is regular pressure care involving massage and stimulation of the area, promoting circulation. You mention shoes and socks-how mobile are your patients?

[CathyLew]

are these diabetic patients? do you have some policy on foot care for diabetic patients where you work? that is the only thing I can think of....

we used to have to do a daily foot check on all DM patients.

[CathyLew]

or....it sounds like a policy or protocol that someone sitting behind a desk made up......

[anonymous1919, LPN]

No, I don't see the point of that either!. The only thing I know (but I've been out of the field of LTC a LOOOOONG time!) is that the only "effective" treatment is regular pressure care involving massage and stimulation of the area, promoting circulation. You mention shoes and socks-how mobile are your patients?

Some are very mobile, some bedridden. Maybe it's not so much the skin prep that is important but more of the massaging/stimulation going on when putting on the skin prep? That's about the only thing that has made sense so far.

[anonymous1919, LPN]

are these diabetic patients? do you have some policy on foot care for diabetic patients where you work? that is the only thing I can think of....

we used to have to do a daily foot check on all DM patients.

Actually none of my patients who currently have skin preps bid to heels are diabetic. It seems like they just choose at random who needs it tbh! Only *some* of my bedridden patients have it.

[Flo., BSN, RN]

The only thing I know (but I've been out of the field of LTC a LOOOOONG time!) is that the only "effective" treatment is regular pressure care involving massage and stimulation of the area, promoting circulation.

Through research that has actually shown to increase the chances of developing a pressure ulcer. So now we make sure the heels are off the bed, use waffle booties, get the pts OOB and preform frequent visual inspections.

As for the skin prep I have never heard of that.

[JenniferSews]

I have often wondered this myself. The thinking is that over time it helps harden and protect the skin. I haven't found much to back up this theory, but it is the standard treatment at my facility.

[anonymous1919, LPN]

I have often wondered this myself. The thinking is that over time it helps harden and protect the skin. I haven't found much to back up this theory, but it is the standard treatment at my facility.

How would hardening help prevent skin breakdown? Pressure is pressure... no?

[86toronado, BSN, RN]

I put skin prep on the heels and elbows of patients who are completely bedridden, and tend to slide down in bed. That way the friction when they are pulled up repeatedly does not cause soreness, or shearing in those areas anyway. Why you would put it on people who are wearing shoes and socks and OOB is beyond me...