title: What do we know about skin-hygiene care for patients with bariatric needs? Implications for nursing practice.
abstract: OBJECTIVE
  This article presents a discussion of the current state of knowledge about bariatric skin-hygiene care and whether this is sufficient to underpin evidence-based nursing practice.
  
  
  BACKGROUND
  The challenges of providing bariatric skin-hygiene care are highlighted and include managing specific skin changes with associated risk of skin breakdown and practical management needs. The risk of skin breakdown is high and can have a devastating impact on well-being and increased treatment costs.
  
  
  METHODS
  A four-stage search strategy included: (i) literature search using electronic databases from inception-May 2013; (ii) hand search of selected journals; (iii) review of internet-based guidelines, policies or protocols and (iv) contact with clinical experts.
  
  
  CONCLUSIONS
  There is a dearth of robust evidence on bariatric skin-hygiene care. Whilst a range of information and guidelines exist, these are generally based on expert opinion and often used only in a local context.
  
  
  CONCLUSIONS
  Nurses are increasingly faced with the challenge of providing skin-hygiene care for patients with bariatric needs. At present, care is largely based on custom and practice or clinical opinion; this limits capacity to provide optimum evidence-based nursing care.
  
  
  CONCLUSIONS
  As the prevalence of people needing bariatric skin-hygiene care continues to increase, there is a lack of evidence to inform interventions and hence a growing need for further research in this challenging clinical area to help nurses and patients select the best possible interventions that will meet individual personal-hygiene needs and preserve skin integrity.
authors.affiliation: Faculty of Health and Social Care, University of Hull, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Cowdell
authors.forename: Kathy
authors.initials: K
authors.lastname: Radley
mesh_terms: D049088:Bariatrics; D055318:Evidence-Based Nursing; D006301:Health Services Needs and Demand; D006801:Humans; D006920:Hygiene; D024802:Nurse's Role; D017592:Skin Care
keywords: bariatric; evidence-based nursing; hygiene; skin; skin integrity