The skin breakdown. i.e. the destruction of soft tissues is a disregarded situation. Believing that children are not exposed to tissue damage is wrong. On the contrary, they are at greater risk of prejudices subsequent to the action of forces such as pressure, friction and stretching. Before replacing a feeding, peristomal, ventilation and / or respiration device it is necessary to inspect the skin, optimize nutrition, managing the environmental humidity and verify the integrity of the devices. It is important not to follow the routine or the time expiration.Replacing devices taking into account the assessment of the skin breakdown gives similar results in terms of cost and secondary complications and is less stressing for the child.