NEONATAL SKIN CARE

作者：Gary Lee Darmstadt, JAMES G. H. DINULOS · 发表于：Pediatric Clinics of North America · 年份：2000 · DOI：10.1016/s0031-3955(05)70239-x · 被引用次数：191 · 研究领域：Neonatal skin health care、Pediatric health and respiratory diseases、Pressure Ulcer Prevention and Management

The skin acts as an interface between the internal milieu and the environment and provides many functions essential for human survival, including: Modulation of transepidermal water fluxes, protection from dehydration and excessive water influx, and maintenance of electrolyte homeostasis Thermoregulation and minimization of caloric losses Antimicrobial defense Protection from environmental toxins Protection from trauma Protection from ultraviolet radiation Tactile sensation Structural immaturity Stratum corneum and epidermis are thinner than in term infants. Anchoring fibrils, anchoring filaments, and hemidesmosomes are fewer and smaller than in term infants, leading to decreased anchoring of the epidermis and increased susceptibility to shear forces. Stratum corneum epidermal permeability barrier is underdeveloped, leading to increased transepidermal water loss, loss of heat, increased caloric demands, increased potential for absorption of environmental toxins, and compromised antimicrobial defense. Expression of cationic antimicrobial peptides may be developmentally decreased. Antibacterial acid mantle forms more slowly in neonates weighing less than 1 kg than in larger, more mature neonates. Formation of a protective layer of vernix is underdeveloped. Decreased numbers of melanocytes with immature melanosomes leads to increased susceptibility to ultraviolet light–induced damage. A reduced subcutaneous fat supply limits thermoregulatory capabilities and buffering capacity a...