Skin Prep- waste of time?

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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

:rolleyes:

Skin prep is often used to protect heels from becoming boggy or when heels have already developed unstageable eschar (thick black scab) to allow heels to heal from the inside without disturbing scab and thus creating a wound. It may be a pain to apply skin prep BID but it is much easier than doind wound care BID!

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Specializes in Peds Medical Floor.

We use it too, on seemingly random people too. Heels, bunions, etc. 3 times a day for months or yrs at a time. Never made much sense to me either.

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Specializes in PACU, OR.
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.

For mobile patients it seems a complete waste of money, unless they are trying to prevent the heels cracking. There are excellent foot creams out there which are very good at preventing heel cracks; in fact, if I consider what it's probably costing to apply S&N products to the heels twice a day, it might be a better idea just to get a podiatrist in on a regular basis to give foot treatments for the mobile patients.

Flo's post gives the best suggestion for bedridden patients; I remember from my LTC days in the mid 70s that the massage bit was like King Canute trying to hold back the sea-no matter how hard we tried, those dreaded red patches would appear....

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yup--that is pretty common practice here in upstate NY. I think it does help. Skin prep actually creates a barrier, a thin film. So shear is decreased a little when things rub against the skin its rubbing against the film and not directly on the skin. I use skin prep a lot and love the stuff. I use it on every patient when I have to put on adhesives and they stay better and hurt the patient less on removal. And for those elderly folks with "onion" skin it is a must so as to not cause more skin tears.

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It is also used to prevent pressure areas from breaking down. It does work. Better than say a tegaderm that pulls the skin.

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Specializes in Step-down, cardiac.

I'm a new nursing student, and one of the first things we were taught about pressure ulcers is that skin prep is now a research-recommended treatment for Stage I pressure ulcers (along with transparent dressings). Also, massage is definitely no longer recommended! As a previous poster said, it's been shown to make pressure sores more likely to occur and worse once a patient has one.

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Specializes in LTC.
yup--that is pretty common practice here in upstate NY. I think it does help. Skin prep actually creates a barrier, a thin film. So shear is decreased a little when things rub against the skin its rubbing against the film and not directly on the skin. I use skin prep a lot and love the stuff. I use it on every patient when I have to put on adhesives and they stay better and hurt the patient less on removal. And for those elderly folks with "onion" skin it is a must so as to not cause more skin tears.

I love this stuff too..so much, I have brought in at my facility. They never used it before and when I mentioned it to a unit manager, she did some research and started using it as a pro active treatment and have seen amazing results. We use it on heels, elbows, coccxy and esp those residents with paper thin skin and refuse to wear a "sleeve", we use it on their forearms...

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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?

Really? It's been drilled into my head to NEVER, EVER massage pressure areas or bony prominences. Our certified wound care nurse has posters of do's and don'ts up everywhere and this is always listed as a DON'T.

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Specializes in Home Care.

We might just end up dipping their bodies in skin prep :)

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Specializes in Professional Development Specialist.

Can anyone link me to a study? I haven't been able to find anything related to wound prevention.

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Specializes in General.

On bedridden patient I had proved that changing position Q2H is already solving things. I had one in the past, a patient with Parkinson's disease with body stiffness 24-7, for three full years. It was in Arab's country. No single pressure ulcer developed by turning the pt routinely. You know why? Because we will have our salary cut if they find us neglecting the procedures and ulcer developed. :-)

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Specializes in Alzheimer's, Geriatrics, Chem. Dep..

In theory it is like an extra layer. You have to make sure it is not tacky but completely dry when you put on their socks. It's almost like putting a layer of clear nailpolish on them (tho of course not as thick a layer). This could be an "old nurses' tale" too - but it does seem to help (Unless of course they live in their shoes and socks). I would assume that this is on unbroken (examined) skin, and that the feet are clean and dry when it's applied.

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