Tegoderm to Skin of ELBW

Improved Outcome of Extremely Low Birth Weight Infants with Tegaderm^ Application to Skin. Bhandari V, Brodsky N and Porat R. Journal of Perinatology (April 2005); 25:276-281.

Design: We reviewed charts of ELBW infants (BW<1.0 kg) born during 24 months prior to Tegaderm^Ò application and 19 months after starting Tegaderm^Ò.

Results: Throughout the first week of life, serum Na levels, daily fluid intake and daily weight loss were significantly higher in the NOTEG infants (all P

0.04) while BUN/Serum creatinine levels were similar. Hypernatremia (Na>150 mEq/l) developed in 51% of NOTEG infants compared to 17% of TEG (P=0.0005) and daily fluid intake

170 ml/kg/day was required in 54 vs. 13% (P=0.0008), respectively. The mean time to regain BW was significantly longer in NOTEG vs. TEG infants, 20.7±7.4 vs. 15.8±6.3 days, respectively (P<0.02). There were no statistical significant differences among the groups in incidence of IVH, NEC, PDA or nosocomial sepsis; however, respiratory outcome was better in TEG infants. They had significantly less BPD (58% in NOTEG vs. 22% TEG (P=0.01)) and fewer infants in the TEG group required supplemental oxygen at discharge (58% vs. 22% (P=0.01)). Survival was significantly higher in TEG 90% vs. 64% in NOTEG infants (P=0.02).

Comment: This study compared rates of survival, BPD, early hypernatremia, and daily fluid volumes in ELBW infants 24 months before and 19 months after routine dermoprotection of the torso and all extremities with a semipermeable polyurethane membrane (Tegaderm®) was instituted in 1992 at a single nursery. Results were striking: survival increased from 64% to 90%; the incidence of BPD decreased from 58% to 22%; the frequency of hypernatremia fell from 51% to 17% despite a drop in the number of infants who received more than 170 ml/kg/d from 54% to 13%. Stage 3 ROP was also reduced post Tegaderm, from 48% to 16%. These results beg for units with clinical equipoise to conduct a randomized controlled trial. MLH.

Date: 26 Apr 2005
Time: 07:05:51

The concept sound's very interesting but what was the damage to the fragile neonatal skin. The only time we use tagadern to the skin is to cover the long line site. Was a skin protection agent such as cavalon spray used pre application of the tagaderm to prevent damage to the preterm skin, we use the spray pre application of adhesives to the preterm skin and we have less problems with skin damage.

UserName: Joanne O'Donnell ANNP
Institution: Hope Hospital Salford England
telephone: 01706 373458
email: joanne.odonnell@tesco.net

You may add your own comments to the discussion of this topic by selecting : Submit Comments.