When a baby has gross edema and skin is extremely tense and breaking at many points and making many points vulnerable to pressure necrosis, what is the best way to care for the skin in these circumstances ? Kindly send some references also. I will also appreciate if some skin care guidelines of Neonate are also shared .

Some thoughts from a former pathophysiologist: the aim is to restore skin microcirculation. You surely tried to modify most of the components of edema formation, phlebohypertension (RF? HF?), oncotic/hypoproteinaemia, membranogen (sepsis? etc), but what can we do with the lymphatic component? At first, lymphatic insuff is dynamic, more efflux than the capacity, but beyond a point mechanical component (compression by the edema) becomes also important. Can we help the lymphatic system to bring back the excess fluid, to give space for the microcirculation? Lymphatic massage is well known in adults, but is there anybody practising it in NICUs as a therapeutic tool?