Skin management is crucial in maintaining the skin integrity of neonates in the neonatal intensive care unit (NICU). A recent guideline was established on the best evidence at home and abroad, using Grading of Recommendations Assessment, Development and Evaluation (GRADE) to grade the evidence, and much-soliciting neonatologists, nurses, dermatologists, wound ostomy, and experts in evidence-based medicine Created after deferring for peer expert opinions. 

This includes a total of 30 recommendations: including 0 for A-level, 6 for B-level (20%), 10 for C-level (33%), and 14 for D-level (47%). Guidelines for routine skin care management like bathe, buttocks care, umbilical care, emollient, disinfectant etc are described. Additionally, for iatrogenic skin injuries also various skin care recommendations are provided.

For skin management, the special content is utilized (like medical adhesive-related skin injury, medical device-related pressure injury, and intravenous fluid leakage injury), and it was challenging to conduct RCT studies. The best evidence available after retrieval, and balancing the pros and cons of interventions for NICU neonates, suggest recommendations for clinical reference. 

Applying guidelines may face barriers like lack of materials and high costs, such as lack of tannic acid ointment, Silicone dressings and disposable wipes for babies are pricey and should be carried out based on the actual situation of the unit. For some details involved in skin management, due to the lack of relevant evidence support, this guideline did not completely describe. Further, this guideline plans to 3 Updated once a year.

Evidence-based Professional Committee of the Chinese Medical Doctor Association Neonatologist Branch. Guidelines for the management of neonatal skin in the intensive care unit (2021) [J]. Chinese Journal of Contemporary Pediatrics, 2021, 23(7): 659-670.