Skin InteGrity in extreme preterms research NETwork (SIGNET) - improving skin care for the most immature infants

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Abstract
Increased survival of preterm infants born <28 weeks’ gestation brings new challenges for healthcare teams and families, particularly in the absence of high-quality, population-specific evidence to guide optimal skin care. Skin integrity is critical for preventing infection, reducing pain, and minimizing fluid loss. However, variations in care, delivery models, geographic settings, and clinician expertise continue to influence outcomes—impacting both immediate survival, long-term morbidity and mortality. This review outlines the key challenges associated with delivering safe and effective skin care for extremely preterm infants; identifies priority areas for research and benchmarking, and proposes a collaborative approach to address these gaps. The Skin InteGrity in extreme preterms research NETwork (SIGNET) collaborative seeks to align outcome measures, generate essential physiological data, promote knowledge exchange, and develop practical, evidence-based tools to support consistent, high-quality care for these uniquely vulnerable patients.

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