Prospective, Case-Control Study Evaluating Effects of No-Sting Liquid Barrier Film on Skin Condition and Maturation of Stratum Corneum in Premature Neonates.

Purpose: To assess effects of a no-sting liquid barrier film (NSLBF) on the skin condition and maturation of the stratum corneum in premature neonates.

Design: This was a prospective, case-control study with each subject serving as their own control.

Subjects And Setting: The sample comprised 33 neonates, between 23 and 32 weeks of gestational age (GA). Participants received care in a level 4 neonatal intensive care unit in the northeastern United States. Data were collected between May 2018 and May 2019.

Methods: All participants had NSLBF applied to their left chest, left abdomen, and left anterior and posterior upper thigh. The right side was left untreated and served as self-control. Measurements of skin pH, hydration, transepidermal water loss (TEWL) and Neonatal Skin Condition Scores were obtained on both the untreated right and treated left sides of the body over a 14-day period on days 1, 3, 7, and 14.

Results: Worsening skin condition scores were observed on the treated side on days 7 and 14. There was an improvement in TEWL on the treated side, manifested as decrease in TEWL values. There was no difference in pH. At all points in time hydration was lower on the treated side.

Conclusions: Worsening skin condition scores and hydration status on the treated side indicate an altered or delayed process of skin maturation. These findings suggest that no-sting liquid barrier (NSLB) application should be limited to skin under medical devices, dressings, tapes, and affected areas. In addition, we recommend allowing adequate intervals to allow physiologic stratum corneum maturation between applications of NSLB.