The promotion and maintenance of skin integrity is one of the most common challenges for nurses in every sphere of practice, but particularly for those caring for patients with chronic inflammation of the skin (such as in eczema and psoriasis), and to those at risk of skin breakdown due to immobility, circulatory disease, or incontinence. A significant amount of nursing time is spent washing patients, or assisting them to wash. However, little attention has been given to a scientific appraisal or evidence of the effectiveness of these activities.