A newly published randomised controlled trial has demonstrated that structured skin protection using a twice-daily application of a pre-packaged non-woven wipe impregnated with emollient and barrier properties (Contiplan™) can significantly reduce pressure injuries in older adults when used alongside standard prevention measures.

Pressure injuries remain one of the most significant and persistent challenges across healthcare and aged-care settings worldwide. Despite decades of focus on prevention, they continue to contribute to avoidable patient harm, increased healthcare utilisation, prolonged recovery and reduced quality of life – particularly among older adults and people with limited mobility.

For many years, prevention strategies have understandably focused on reducing pressure through repositioning, support surfaces and mobility interventions. Yet pressure injury development is multifactorial. Skin exposed to ongoing moisture, friction and shear becomes increasingly vulnerable to breakdown, particularly in frail, incontinent or immobile patients.

While skin care has long been recognised as important in maintaining skin integrity, comparatively little high-quality evidence has explored its role as a proactive pressure injury prevention strategy.

That may now be changing.

A recently published multicentre randomised controlled trial in BMJ Open evaluated whether structured skin protection using a twice-daily application of a pre-packaged non-woven wipe impregnated with emollient and barrier properties (Contiplan™) could reduce pressure injury incidence when used alongside standard prevention measures.

Conducted across 20 residential aged-care facilities in metropolitan and rural Australia, the study involved 858 adults aged 65 years and older identified as being at risk of pressure injury development. Participants continued to receive established prevention measures including repositioning and pressure redistribution surfaces, with the intervention group additionally receiving twice-daily application of a pre-packaged non-woven wipe impregnated with emollient and barrier properties (Contiplan™) to the sacrum, buttocks and heels.

The study demonstrated:

• At 120 days, 97.4% of residents in the intervention group remained pressure injury-free compared with 91.6% in the standard care group
• This equated to pressure injury rates of 2.6% versus 8.4%, representing a 5.8% absolute reduction and an approximate 69% relative reduction in pressure injuries over the study period
• A 50% reduction in overall pressure injury incidence rate in the intervention group compared with standard care alone (Incidence rate ratio: 0.50 [95% CI, 0.31–0.81]; p=.005)
• Pressure injury incidence rates were halved: 0.31 vs 0.62 per 1,000 consumer days
• Time to first pressure injury was significantly prolonged (HR=0.47, 95% CI 0.29–0.74; p<0.01)
• Stage II pressure injuries were significantly reduced: 1% vs 6% (p<0.01)
• A trend toward reduced incontinence-associated dermatitis was observed (0.24 vs 0.36 per 1,000 consumer days)
• The intervention was simple, non-invasive and designed to integrate into routine care workflows using a standardised approach focused on high-risk anatomical areas
• Benefits were achieved in addition to – not instead of – established prevention strategies such as repositioning and support surfaces

Importantly, the intervention evaluated in the study was designed to integrate into routine care workflows using a simple, standardised approach focused on high-risk anatomical areas.

Why skin protection matters

Healthy skin plays a fundamental role in protecting against pressure-related tissue damage. However, ageing skin is inherently more fragile and vulnerable to external stressors. Moisture exposure, friction and shear can compromise the skin barrier, reducing tissue tolerance and increasing susceptibility to breakdown.

For patients who are incontinent, frail, malnourished or unable to reposition independently, these risks are often amplified.

The study reinforces an important shift in thinking: pressure injury prevention is not solely about managing pressure. Protecting skin integrity may also play a critical role in reducing risk.

The wipe evaluated in the study was designed to support skin hydration while helping protect against moisture and friction-related damage. The intervention targeted common high-risk areas for pressure injury development, including the sacrum, buttocks and heels.

Interpretation

Pre-packaged non-woven wipe impregnated with emollient and barrier properties (Contiplan™)

• Reduced trans epidermal water loss (TEWL)
• Enhanced structural skin resilience
• Reduce susceptibility to friction and sheer

Simple interventions can have meaningful impact

One of the most important aspects of the study is its practical relevance.

Healthcare and aged-care providers continue to operate within increasingly pressured environments where workforce constraints, time limitations and variation in care delivery remain ongoing challenges. Interventions that are evidence-based, scalable and straightforward to implement are therefore particularly valuable.

The structured use of emollient and barrier wipes evaluated in this trial was:

• Non-invasive
• Standardised
• Easy to integrate into routine care
• Delivered alongside – not instead of – existing prevention bundles

This matters because successful prevention strategies must not only demonstrate clinical benefit, but also be practical and sustainable in real-world care environments.

A broader conversation about prevention

The publication of this study contributes to a growing body of evidence highlighting the importance of proactive skin protection strategies in vulnerable patient populations.

As healthcare systems continue to focus on reducing avoidable harm and improving quality outcomes, prevention pathways must continue to evolve beyond single-intervention thinking. Effective pressure injury prevention requires a multifactorial approach that recognises the interaction between pressure, mobility, moisture, friction, shear and skin resilience.

This study provides robust new evidence supporting the role of structured skin protection as part of comprehensive pressure injury prevention strategies.

We thank the authors for their contribution and publishing research that supports transparency, critical inquiry and ongoing advancement within the field.