What can be applied to facial abrasions under a nasal cannula (NC) to promote healing?

Protective Barriers Under Nasal Cannulas for Facial Abrasions

Apply a thin layer of petroleum-based ointment (such as plain white petrolatum or petroleum jelly) directly to facial skin under the nasal cannula to prevent and manage abrasions. 1, 2

Primary Recommendation

Use plain white petrolatum (petroleum jelly) as the first-line protective barrier under nasal cannulas. This approach is supported by wound care guidelines and has lower rates of skin reactivity compared to other petrolatum-based products. 1, 2, 3

Application Protocol

• Clean the affected area with running tap water or sterile saline before applying any protective barrier 1, 2
• Apply a thin layer of petroleum jelly to intact skin where the nasal cannula contacts the face, particularly around the nares, cheeks, and ears 2, 4
• Cover existing abrasions with the petroleum-based ointment and an occlusive dressing if the wound is already present 1, 2
• Reapply every 4 hours when repositioning or adjusting the nasal cannula to maintain continuous protection 5

Alternative Protective Measures

If petroleum jelly alone is insufficient or if more significant skin breakdown has occurred:

• Use hydrocolloid or foam protective dressings under pressure points where the nasal cannula contacts skin 5
• Alternate the position of the nasal cannula every 4 hours to redistribute pressure and reduce friction injury risk 5
• Consider softer nasal cannula materials (non-polyvinyl chloride options) which cause fewer pressure injuries 5

Important Clinical Considerations

Product Selection Caution

Avoid Aquaphor Healing Ointment and similar complex petrolatum-based products for routine prophylactic use under nasal cannulas, as they demonstrate significantly higher rates of wound redness (52%) compared to plain white petrolatum (12%). 3 Plain petroleum jelly is safer and equally effective for maintaining skin moisture and preventing friction injuries. 2, 3

When to Seek Medical Evaluation

Monitor for signs of infection or worsening skin breakdown: 1, 2

• Progressive redness extending beyond the contact area
• Increased pain or tenderness
• Purulent drainage or foul odor
• Fever or systemic symptoms
• Swelling that worsens despite protective measures

Wound Care for Established Abrasions

If abrasions have already developed: 1, 2

• Irrigate thoroughly with tap water or sterile saline until no debris remains 1
• Apply antibiotic ointment to the cleaned wound if no allergies exist 1, 2
• Cover with an occlusive dressing to maintain moisture and promote healing 1, 2
• Change dressings when repositioning the nasal cannula or if they become soiled 2

Prevention Strategy

The most effective approach combines: 5

• Prophylactic petroleum jelly application to high-risk contact points
• Regular repositioning of the nasal cannula every 4 hours
• Use of protective foam or hydrocolloid dressings at pressure points
• Staff and patient education on early recognition of skin changes

This multi-component prevention strategy has demonstrated elimination of medical device-related pressure injuries in clinical trials when implemented consistently. 5