Pressure ulcers in maturing skin - A clinical perspective.

While the problem of Pressure Ulcers (PU) in adults has received a great deal of attention, far less is known about PUs in neonates and children. The overall health status of children is generally better and multi-morbidity is limited to a small percentage of patients, like very low term neonates (born before 32 weeks of gestation age), newborns with congenital abnormalities, genetic disorders, perinatal distress syndrome or children with a limited immunity. Survival rates of both critically and chronically ill neonates, infants and children have improved dramatically in recent years, introducing new challenges for medical and nursing care. Children's skin undergoes several changes throughout the first 18 years of life. The most important function of the skin is to protect against water loss, absorptions of noxious substances, intrusions of microorganisms and physical trauma. Effective PU prevention includes device related under-padding and careful positioning and fixation of such devices. At least regular head-to-toe-skin assessment of neonates and infants at risk of PUs should be performed.