Elizabeth Day Dechant, BSN, RN, CWOCN, CFCN

Hospitalized patients of all ages are at risk for iatrogenic injuries. Peripheral intravenous extravasation and infiltration (PIVIE) injuries are one of the most common types of hospital-acquired injury, with the potential to cause long-term disfigurement or loss of function. While the administration of fluids and medications through intravenous catheters is a common practice in the hospital, it is not without significant risk if fluids leak from the vasculature into surrounding tissues. Depending on the type and amount of fluid that enters the tissue, varying degrees of tissue damage may result. The pathophysiology of this tissue damage may also vary.

The benefit of Negative Pressure Wound Therapy (NPWT) as an “active,” adjunctive treatment is well-established. Evidence has shown that wounds treated with negative pressure granulate faster than wounds managed with traditional dressings. There is ever-increasing literature to support the use of NPWT to treat wounds effectively and safely in even the youngest patients.1 Some specific benefits of NPWT for pediatric and adolescent patients include decreased frequency of dressing changes, as well as a dressing that is occlusive and unlikely to be removed by the patient.

Peristomal skin complications (PSCs) include inflammation, injury, or damage to the skin surrounding an abdominal stoma. PSCs are among the most common challenges faced by people living with an ostomy, with as high as 80% reported incidence. Complications are highest in individuals with an ileostomy.  Some of the most common PSCs in individuals with stomas for fecal diversion

Diaper rash, more officially known as incontinence-associated dermatitis (IAD), affects hospitalized and incontinent patients of all ages. In my years as a WOC Nurse in a pediatric hospital, IAD has been by far the most frequently treated condition. However, outside of a health care setting, IAD is the most common skin problem in infants and young children who are not yet toilet trained. Diaper rash has plagued babies and new parents for centuries, yet its treatment remains highly debated. For the purpose of this article, I am focusing on the prevention and treatment of diaper rashes in infants and young children, although the principles of topical treatment discussed here apply to all patients.