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?
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
We haven't ever used skin prep at our facility, but betadine. How does skin prep work on tape blisters? Some of our patients have terrible reactions to tape after surgery, and it seems there is no good way to treat the blister.
I really like skin prep and was taught that it is an effective way to 'toughen' up skin in areas prone to break down like heels, elbows, behind ears on people with oxygen tubing etc. I've seen it work in just a couple days to helping a stage 2 behind an ear close up, and our people who get skin prep TID all have nice, non-reddened heels. Application has to be consistent, I'm not sure once a day is enough. Our protocol is usually 2-3x daily, depending on the pt.
I had a patient that I was treating for a great toe infection. The podiatrist also ordered skin prep to his heels BID. He was diabetic but well controlled. His heels had thick dry rugged callouses on them. Well, after a few weeks the callouses dried up, fell off, and reveiled a thick smooth normal heel. I was flabbergasted and won't question that practice again.
I had a patient that I was treating for a great toe infection. The podiatrist also ordered skin prep to his heels BID. He was diabetic but well controlled. His heels had thick dry rugged callouses on them. Well, after a few weeks the callouses dried up, fell off, and reveiled a thick smooth normal heel. I was flabbergasted and won't question that practice again.
Old wives' tale about callouses; apply clear nail varnish. If you look at commercial treatments for callouses you will find that they also provide an impenetrable film to the affected area (sorry, can't remember the name of the one I used) and eventually they do fall off.
To Notflo; I see you are 33; I was last in LTC in 1976, ie before you were born, and in those "days of the dinosaurs" massage was drummed into our heads. However, if you read my response to the real Flo's post, you will realize that I concede my outdated information to her obviously more modern approach.
I'm not familiar with skin prep as such, but I do know that products that are commonly in use in 1st world countries are prohibitively expensive elsewhere.
I had a pt on wednesday who had orders for "skin prep to both heels BID". She wasn't diabetic but she was bedbound. But yeah, I don't see how it prevents pressure...
skin prep, i was wondering the same thing. i work for a ltc facility too and i just don't understand what good it does especially when its over used just to show some sort of treatment is in place for the resident. i first came home to see if i could find evidenced based practice on this skin prep because as we nurses know that our whole practice is built and based on evidenced based information. i could not find any article that stated anything positive but i did see multiple postings regarding skin prep. so my question is, is this nursing????? or is this someone's observation? i struggle with the fact that skin prep is helping at all when most elderly wear socks and the constant friction of removing the socks to apply the skin prep would contraindicate the action all together. the main reason i looked this up was to see if this action was some where in the nursing world because i am a new nurse and have not heard or seen this being thought in the school i attended. there was the skin prep and the betadine, was the other intervention???? what about the betadine? why put betadine on a scab? does anyone know that?
Hello Internet! In case you stumbled here from googling skin prep:
Skin prep is the brand of dressing called a "Barrier Film." That's what you want to Google. TL;Dr-
Barrier films are recommended as moisture barriers and reducing the damage on removing a dressing. Neither of which applies to intact heels. However, they will reduce friction which does prevent pressure injuries. Whether it should be used on everyone is an internal policy debate. Further reading:
Bodkhe RB, Shrestha SB, Unertl K, Fetzik J, McNulty AK. Comparing the physical performance of liquid barrier films. Skin Res Technol. 2021 Sep;27(5):891-895. doi: 10.1111/srt.13038. Epub 2021 Mar 24. PMID: 33760305; PMCID: PMC8596591.
Bernatchez SF, Mengistu GE, Ekholm BP, Sanghi S, Theiss SD. Reducing Friction on Skin at Risk: The Use of 3M™ Cavilon™ No Sting Barrier Film. Adv Wound Care (New Rochelle). 2015 Dec 1;4(12):705-710. doi: 10.1089/wound.2015.0628. PMID: 26634182; PMCID: PMC4651030.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
Skin prep is great to protect against shearing. But why in the world would you do it for someone who is wearing shoes and presumably walking around? No.
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rudeRN
21 Posts
We haven't ever used skin prep at our facility, but betadine. How does skin prep work on tape blisters? Some of our patients have terrible reactions to tape after surgery, and it seems there is no good way to treat the blister.