Moisture-associated skin damage and its management in neonatal and infant populations: a retrospective study in Italy

Objective: Moisture-associated skin damage (MASD) is a significant concern in the paediatric population, particularly among neonates, who exhibit the highest incidence due to their highly sensitive and fragile skin. The aim of the study was to identify the most effective treatment. Method: A retrospective observational study was conducted at Meyer Children's Hospital IRCCS, Florence, Italy. Data from infants admitted to the neonatal intensive care unit of the hospital were collected from electronic health records. Demographic, clinical and nursing data were analysed to identify the key clinical features of MASD lesions, including their severity, healing time, and the relationship between MASD lesions and treatment approaches. Results: The cohort comprised 102 infants (mean age 2.92 months). Incontinence-associated dermatitis (IAD) accounted for the majority (78.4%) of MASD lesions. Among patients with IAD, most exhibited persistent redness (26.3%) or skin loss (47.5%) without clinical signs of infection. In contrast, peristomal MASD cases constituted 21.6% of the total, with the majority classified according to the Study on Peristomal Skin Alterations (SACS) 2.0 as L2 erosive lesions (63.6%), predominantly occurring in quadrants 2, 3 or 5. A novel treatment (Vulnamin; Professional Dietetics S.p.A., Italy) was used to manage MASD lesions in 64.7% of patients. This innovative treatment significantly (p<0.001) reduced healing time by an average of 2.4 days and decreased the odds of relapse by 5.3 times compared with traditional treatments. Conclusion: The findings of this study showed that use of effective MASD therapies can reduce healing time and relapse rate, leading to decreased nursing hours and associated costs.