Background: Wounds at the sacral area are very difficult to treat, especially in patients who have incontinence. Wound contamination causes delayed wound healing and infection. More frequent wound cleansing leads to a high cost and spent more time to change the dressing. Deep creasing skin between the buttocks is the main cause of feces or urine penetration through the wound covering. The use of a skin barrier to create a dam will obstructs the skin crease and making it difficult for effluent to penetrate into the wound.

Objective: To assess the benefit of a skin barrier to reduce the costs and time spent on wound cleansing. Materials and methods: The barrier is built by a skin barrier of paste and sheet. The skin barrier paste is put into the skin crease between the buttocks and then a skin barrier sheet is put on top followed by cleansing and covering of the wound.

Results: Three cases are reported. All had a pressure ulcer at the sacral area and fecal incontinence. Mean wound dressing changes reduced 6.48 times/day, mean time spent in changing reduced 30.83 minutes/day and mean cost savings 662.40 baht/day.

Conclusion: After management with the skin barrier the patients’ dressings were changed much less often than previously resulting in cost savings, reduction in wound cleansing time and a reduced risk of infection. However, this study has limitations in the sample size, the wound healing rate and infection rate was not studied.