Effect on nosocomial sepsis of topical oil application, skin condition, and care practice device usage in preterm neonates: A randomized controlled trial

Abstract

Introduction: Compromised skin barrier increases the susceptibility of high-risk preterm neonates to nosocomial sepsis. Thus, topical oil application may be a promising strategy for improving neonatal outcomes. Objectives: The objectives of the study were to study the effect of topical oil application on the incidence of nosocomial sepsis and skin condition. Materials and Methods: This randomized controlled trial was conducted in a referral neonatal unit. The study included consecutive preterm neonates admitted before 4 days of age with admission weight of 1000–2000 g. Computer-generated random number sequence was used for grouping neonates in sunflower oil (n=39) and control (n=39) groups. Results: 70 neonates (89.7%) completed the trial. At enrollment, baseline characteristics, clinical features, and lab abnormalities for sepsis evaluation were comparable in two groups. The incidence of nosocomial sepsis was 15.4% and 17.9% in oil and control group (p=0.7613). On day 10 of enrolment, in oil group, all 23 babies, and in control group, only 1 of 21 babies had normal skin (p<0.001). On multiple regression analysis, the odds ratio (95% confidence interval) for care practice device usage (v/s. randomized group and skin condition) in the causation of nosocomial sepsis was 1.189 (1.08?1.298, p=0.002). Conclusions: No difference in the incidence of nosocomial sepsis was observed between the oil and control groups. However, each additional day of care practice devices usage increased the risk of nosocomial sepsis by 1.19 times, despite oil application and/or improvement in the skin condition.