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

Journal of Perinatology (2026)Cite this article

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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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Author information

Author notes

  1. These authors contributed equally: Deanne August, Sabrina de Souza.

  2. These authors jointly supervised this work: Marty Visscher, Pranav R Jani.

Authors and Affiliations

  1. Neonatology, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia

    Deanne August & Gillion Noreiks

  2. Nursing, and Midwifery, Griffith University, Brisbane, QLD, Australia

    Deanne August

  3. Nursing, Midwifery and Social Work, University of Queensland, Brisbane, QLD, Australia

    Deanne August & Sabrina de Souza

  4. Division Neonatology, K. Hovnanian Children’s Hospital, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ, USA

    Vita Boyar

  5. Neonatology, Townsville University Hospital, Townsville, Australia

    Amy Curran

  6. Department of Pediatrics, Division of Neonatology, University of Iowa, Iowa City, USA

    Amy A. Hobson

  7. Dokkyo Medical University, Tochigi, Japan

    Miki Konishi

  8. Miracle Babies Foundation, Sydney, Australia

    Kylie Pussell

  9. Department of Neonatology, Westmead Hospital, Westmead, NSW, Australia

    Hannah Skelton & Pranav R. Jani

  10. Department of Pediatrics and Institute for Clinical Research and Learning Healthcare, McGovern Medical School, UTHealth Houston, Houston, TX, USA

    Matthew A. Rysavy

  11. Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia

    Karen Walker

  12. Council of International Neonatal Nurses, Yardley, PA, USA

    Karen Walker

  13. Colleges of Pharmacy and Medicine, University of Cincinnati, Cincinnati, OH, USA

    Marty Visscher

  14. The Reproduction and Perinatal Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia

    Pranav R. Jani

Authors
  1. Deanne August
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  2. Sabrina de Souza
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  5. Amy A. Hobson
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  6. Miki Konishi
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  7. Gillion Noreiks
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  8. Kylie Pussell
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  9. Hannah Skelton
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  10. Matthew A. Rysavy
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  11. Karen Walker
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  13. Pranav R. Jani
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Contributions

DA,, SdS and PJ were involved in the conception, drafting, writing (draft and review), collecting information included, resourcing, referencing, editing, and completing the manuscript. VB was involved in collecting information included, writing, referencing and editing the manuscript; AC was involved in writing, referencing and editing the manuscript; AH was involved in was involved in writing, referencing and editing the manuscript; MK was involved in was involved in writing, referencing and editing the manuscript; GN was involved in was involved in writing, referencing and editing the manuscript; KP was involved in was involved in writing, referencing and editing the manuscript; HS was involved in was involved in writing, referencing and editing the manuscript; MAR was involved in collecting information included, writing, referencing and editing the manuscript; KW was involved in conceptualising, writing, referencing and editing the manuscript; and MV was was involved in conceptualising, writing, referencing and editing the manuscript.

Corresponding author

Correspondence to Deanne August.

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August, D., de Souza, S., Boyar, V. et al. Skin InteGrity in extreme preterms research NETwork (SIGNET) - improving skin care for the most immature infants. J Perinatol (2026). https://doi.org/10.1038/s41372-025-02487-8

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