What can help alleviate skin irritation caused by medical tubing?

Management of Tubing-Related Skin Irritation on the Cheek

Apply a barrier cream or film containing zinc oxide to protect the irritated skin, combined with proper tube securement to minimize friction and movement. 1

Immediate Skin Protection Measures

The most effective approach for tubing-related skin breakdown involves barrier protection rather than petroleum jelly alone:

• Apply zinc oxide-based barrier cream, paste, or film to the affected area to create a protective layer between the skin and the tubing 1
• Use foam dressings rather than gauze underneath or around the tube contact points, as foam lifts moisture away from the skin while gauze contributes to maceration 1
• Apply low-adherent padding or dressings (such as Mepitel or similar products) between the tube and the skin to reduce direct friction 1

Tube Securement and Positioning

Proper tube management is critical to prevent ongoing irritation:

• Secure the tube with additional fixation devices to minimize traction and movement against the cheek 1
• Use low-adherent tape underneath standard adhesive tape when securing tubes to facial skin 1
• Apply water-based lubricant or emollient to the tube surface where it contacts the skin to reduce friction 1
• Verify there is no excessive tension or pressure from the tube positioning that could worsen skin breakdown 1

Wound Care for Established Irritation

If redness and soreness have already developed:

• Cleanse the affected area at least once daily using soap and water or an antimicrobial cleanser like dilute chlorhexidine 1, 2
• Apply the barrier cream after cleaning and drying the skin thoroughly 1
• Monitor for signs of infection including increased pain, purulent drainage, or spreading erythema 1
• Consider topical antimicrobial agents if there are signs of critical colonization or early infection 1, 2

Why Not Petroleum Jelly Alone?

While petroleum jelly can serve as an emollient and reduce friction 1, 3, it lacks the protective barrier properties of zinc oxide formulations specifically recommended in guidelines for tube-related skin breakdown 1. Petroleum jelly may be used as an adjunct for lubrication but should not replace zinc oxide-based barriers for established irritation.

Common Pitfalls to Avoid

• Do not use adhesive products directly on irritated skin without protective barriers underneath 1
• Avoid leaving the tube unsecured, as movement and friction are primary causes of ongoing skin damage 1, 2
• Do not use gauze directly against broken or irritated skin, as it increases maceration risk 1
• Never ignore signs of infection such as increased warmth, purulent drainage, or worsening pain, which require antimicrobial intervention 1, 2

When to Escalate Care

• If skin breakdown progresses despite barrier protection, consider repositioning the tube to a different location on the face 1
• If granulation tissue develops at the irritation site, daily antimicrobial cleansing and consideration of silver dressings or topical corticosteroids may be needed 1, 2
• If fungal infection is suspected (macerated, white appearance), add topical antifungal agents 1