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However, broadly utilized topical antiseptic agents pose an elevated risk of disruption to neonatal skin integrity, and evidence\u2010based guidelines are lacking. This systematic review of the literature sought to assess and characterize the predisposing risk factors for and types of neonatal skin injury from topical antiseptic agents.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search of Medline Ovid, Embase, Web of Science, CINAHL, and Cochrane Library was conducted, including academic literature providing data on neonatal skin injuries related to topical antisepsis in the NICU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 19 articles (99 patients) met the inclusion criteria. Of the available data, most reported skin injuries were described in extremely preterm (98.1%) and very low birth weight (98.4%) infants. The majority of reported adverse cutaneous events were attributed to chlorhexidine preparations (74.8%), followed by octenidine (18.2%), povidone\u2010iodine (6.1%), and isopropyl alcohol (2.0%). Erythema (40.1%), skin breakdown (23.4%), and chemical burns (17.5%) were the skin reactions reported most frequently, followed by skin irritation (8.3%), and skin necrosis (2.8%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings indicate that both extremely preterm and very low birth weight infants are particularly susceptible to skin toxicities from pre\u2010procedural antiseptic preparations. These data underscore the need for future research to support the development of guidelines which minimize iatrogenic cutaneous injuries in the neonatal population, specifically for the care of infants under 2\u2009months of age, for whom current recommendations are lacking due to a paucity of data.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pde.15773","type":"journal-article","created":{"date-parts":[[2024,10,5]],"date-time":"2024-10-05T05:43:30Z","timestamp":1728107010000},"page":"31-40","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Pre\u2010procedural Topical Antisepsis in the Neonate: A Systematic Review Evaluating Risk Factors for Skin Injury"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2233-4258","authenticated-orcid":false,"given":"Carly","family":"Mulinda","sequence":"first","affiliation":[{"name":"Columbia University Vagelos College of Physicians &amp; Surgeons  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana","family":"Suhail","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center  San Antonio Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bronwyn","family":"Sutherland","sequence":"additional","affiliation":[{"name":"Texas Medical Center Library  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7278-4831","authenticated-orcid":false,"given":"Christine T.","family":"Lauren","sequence":"additional","affiliation":[{"name":"Department of Dermatology Columbia University Vagelos College of Physicians and Surgeons  New York New York USA"},{"name":"Department of Pediatrics Columbia University Vagelos College of Physicians and Surgeons  New York New\u00a0York USA"},{"name":"NewYork\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9507-4912","authenticated-orcid":false,"given":"Raegan D.","family":"Hunt","sequence":"additional","affiliation":[{"name":"Department of Dermatology Baylor College of Medicine  Houston Texas USA"},{"name":"Department of Dermatology Texas Children's Hospital  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(17)31002\u20104"},{"key":"e_1_2_9_3_1","unstructured":"Centers for Disease Control and Prevention \u201cNICU: CLABSI | Infection Control | CDC. 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