Skin Care & Ostomy
Prevention is one of the most important components of wound and ostomy care. Factors like hydration, pressure, excessive moisture, cleanliness and erythema can all affect wound healing rate, patient comfort and the incidence of new wounds. By taking a proactive stance, healthcare professionals implementing a preventative skin care program can reduce the risk of infection, reduce costs and improve patient outcomes. 
Why preventative skin care is important
Wounds affect 35% of all hospice patients and 120,00 new ostomy surgeries are performed each year.   This makes these two of the most prevalent conditions faced by nurses and other healthcare professionals. Taking a proactive stance, focused on preventing wounds and and wound complications before they develop into more serious problems can help reduce additional costs while helping to ensure the patient’s risk is low. Investing the time, resources and energy into properly working on prevention can ultimately pay dividends in the prevention of costly and destructive conditions later on.
Taking a preventative approach
Given the high incidence and cost of wound and ostomy management, taking a preventative approach is an important part of effective care. This approach should combine proper positioning, effective treatment of underlying issues, moisturization, and cleaning. Together, these techniques can help healthcare professionals prevent skin problems that may cause or exacerbate wounds and ostomies. 
Identify risk factors – Understanding the underlying causes of wounds and identifying potential problems before they become more serious is critical to preventative care. Some common risk factors may be incontinence, diabetes and low mobility. Each of these issues can lead to increased risk of infection, increased risk of developing pressure injuries and other skin issues. Patients suffering from any of these conditions should be treated with extra attention and receive regular skin care. 
Implement a preventative regimen – Developing a preventative skin care regimen and making it consistent is critical to minimizing complication. This regimen should consist of several components depending on the underlying risk factors and patient needs. An effective skin care regimen will generally include:
- Repositioning – Regularly repositioning pressure points is extremely important for patients that lack mobility. This can help prevent the risk of pressure injuries. It is also important to limit pressure on areas that are developing erythema or other early signs of pressure injury. 
- Cleaning – Cleaning near wounds, ostomies or in areas affected by incontinence is important to prevent infections and reduce the risk of MASD, IAD or other skin damage.  Caregivers should clean the area with a gentle balanced cleansing solution and a soft cloth to minimize skin irritation. In the case of incontinence, cleaning should be done as soon after the incident as possible. 
- Moisturization & Protection – Keeping skin moisturized is critical to ensuring that it does not become damaged or irritated. After cleaning, caregivers should apply a skin safe moisturizing agent to the affected area. At-risk skin can also be treated with a barrier product that can help limit the effect of excess moisture. 
- Effective medical adhesives and dressing – Using secure adhesives with the right dressings can help reduce the risk that moisture or other foreign material enters the wound area, helping to prevent infection and promote rapid healing. 
Although this is only a brief outline, these techniques will form the basis of effective preventative care.
- Goldberg M. Preventative Skin Care. https://www.npuap.org/wp-content/uploads/2015/02/2.-Preventive-Skin-Care-M-Goldberg.pdf. Accessed May 25, 2017.
- Berlowitz D. Incidence and Prevalence of Pressure Ulcers. Pressure Ulcers in the Aging Population. 2013:19-26. doi:10.1007/978-1-62703-700-6_2.
- o-wm.com. o-wm.com. http://www.o-wm.com/content/ostomy-statistics-the-64000-question. Accessed June 1, 2017.