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Advances in Skin & Wound Care Jun 2020To provide wound care information that considers the specific physiology of neonates. (Review)
Review
GENERAL PURPOSE
To provide wound care information that considers the specific physiology of neonates.
TARGET AUDIENCE
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.
LEARNING OBJECTIVES/OUTCOMES
After participating in this educational activity, the participant will:1. Differentiate the use of hydrocolloids, hydrogels, foam dressings, and barrier creams in the neonatal population.2. Identify issues related to the use of solvents, alginates, collagen dressings, and negative-pressure wound therapy in neonates.
ABSTRACT
OBJECTIVETo discuss what is known about the wound milieu in premature and full-term neonates, including the unique challenges pediatric clinicians face, the therapies that have proven effective, and the therapies contraindicated for use in neonatal wound healing to guide treatment that accounts for the specific physiological characteristics of this often overlooked population.
DATA SOURCES
Data were collected on neonatal wound healing from a wide variety of sources, including PubMed, Google Scholar, journals, and textbooks.
STUDY SELECTION
Selection criteria included publications focused on the differences and nuances of wound healing in neonates in comparison with all other age groups.
DATA EXTRACTION
Data were extracted based on articles covering wound healing therapies with proven effectiveness in neonates. Terms for neonatal wound care were compiled, and then a comprehensive literature search was performed by the authors.
DATA SYNTHESIS
Although many therapies are safe for treatment of older children and adolescents, most have not been explicitly tested for neonatal use. This article reviews therapies with proven effectiveness and/or specific concerns in the neonatal population.
CONCLUSION
This review sheds light on the advantages and disadvantages of current standards of care regarding wound healing for neonates to direct researchers and clinicians toward developing treatments specifically for this delicate population.
Topics: Adolescent; Bandages; Child; Cicatrix; Debridement; Dermatologic Agents; Humans; Infant, Newborn; Negative-Pressure Wound Therapy; Ointments; Skin Care; Wound Healing; Wounds and Injuries
PubMed: 32427785
DOI: 10.1097/01.ASW.0000661804.09496.8c -
Journal of Drugs in Dermatology : JDD Dec 2019The role of skin surface pH, also referred to as “acid mantle,” was described more than 90 years ago and due to developing insights has now returned into focus.1
The role of skin surface pH, also referred to as “acid mantle,” was described more than 90 years ago and due to developing insights has now returned into focus.1
Topics: Humans; Hydrogen-Ion Concentration; Skin; Skin Care; Skin Physiological Phenomena
PubMed: 31860222
DOI: No ID Found -
Dermatologic Therapy Nov 2020Acne is a kind of chronic inflammatory skin disease, which is common in the hair follicle and sebaceous gland of teenagers. It often recurs and affects the quality of... (Review)
Review
Acne is a kind of chronic inflammatory skin disease, which is common in the hair follicle and sebaceous gland of teenagers. It often recurs and affects the quality of life of patients. Acne itself can cause the damage of skin barrier function. On the other hand, common acne treatment methods, such as external drugs, systemic drugs, physical, and chemical treatment, can also lead to the damage of skin barrier function and affect the treatment effect. The application of skin care in the adjuvant treatment of acne has been widely concerned. Due to their high safety, good tolerance, and the effect of improving the damaged skin barrier, medical skin care products are a hot spot in the treatment of cosmetic skin diseases in recent years. It can not only increase the curative effect, reduce the side effects, but also increase the compliance of patients when combined with conventional acne treatment. In this article, skin care products and their application in acne treatment were reviewed.
Topics: Acne Vulgaris; Adolescent; Hair Follicle; Humans; Quality of Life; Sebaceous Glands; Skin Care
PubMed: 32897611
DOI: 10.1111/dth.14287 -
Journal of Wound, Ostomy, and...The Wound, Ostomy, and Continence Nurses (WOCN) Society identified the need to define and promote peristomal skin health. A task force was appointed to complete a... (Review)
Review
The Wound, Ostomy, and Continence Nurses (WOCN) Society identified the need to define and promote peristomal skin health. A task force was appointed to complete a scoping literature review, to develop evidence-based statements to guide peristomal skin health best practices. Based on the findings of the scoping review, the Society convened a panel of experts to develop evidence- and consensus-based statements to guide care in promoting peristomal skin health. These consensus statements also underwent content validation using a different panel of clinicians having expertise in peristomal skin health. This article reports on the scoping review and subsequent 6 evidenced-based statements, along with the generation and validation of 19 consensus-based statements, to assist clinical decision-making related to promoting peristomal skin health in adults.
Topics: Adult; Colostomy; Consensus; Consensus Development Conferences as Topic; Humans; Ileostomy; Ostomy; Skin Care; Societies, Medical; Surgical Stomas
PubMed: 33951712
DOI: 10.1097/WON.0000000000000758 -
British Journal of Nursing (Mark Allen... Aug 2021Disruption to the integrity of the skin can reduce patient wellbeing and quality of life. A major cause of skin breakdown is prolonged exposure to moisture, but this is...
Disruption to the integrity of the skin can reduce patient wellbeing and quality of life. A major cause of skin breakdown is prolonged exposure to moisture, but this is often overlooked. When skin is wet, it becomes more susceptible to damage from friction and shearing forces, and skin flora can penetrate the disrupted barrier, causing further irritation and inflammation. If untreated, moisture-associated skin damage (MASD) can rapidly lead to excoriation and skin breakdown. MASD includes incontinence-associated dermatitis (IAD), which is caused by prolonged skin exposure to urine and stool, particularly liquid stool. For patients at a high risk of developing IAD, preventive measures should be instituted as soon as possible. The main one is to prevent excessive contact of the skin with moisture. Optimal skin care should be provided to patients with any form of MASD. It should be based on a structured regimen and include the use of a gentle skin cleanser, a barrier product and moisturiser. Derma Protective Plus is a liquid barrier that gives long-lasting protection against chafing or ingress of urine and stool into the skin. This product is less greasy than others, and provides a barrier and a healing environment, with resistance to further maceration from IAD or persistent loose stools.
Topics: Dermatitis; Fecal Incontinence; Humans; Quality of Life; Skin Care; Urinary Incontinence
PubMed: 34379461
DOI: 10.12968/bjon.2021.30.15.S40 -
Missouri Medicine 2023A number of chronic skin diseases, such as vitiligo and alopecia areata, are historically resistant to or respond poorly to treatment. Additionally, disorders such as... (Review)
Review
A number of chronic skin diseases, such as vitiligo and alopecia areata, are historically resistant to or respond poorly to treatment. Additionally, disorders such as atopic dermatitis and psoriasis have subtypes that are inadequately treated by current medications. Lastly, in the field of dermatology there are a number of conditions, some genetic (such as Darier's disease and Hailey-Hailey disease) and others caused by aberrant inflammatory responses (macrophage-driven conditions such as sarcoidosis and autoimmune conditions such as localized scleroderma) where effective treatments have been limited to date. A new class of anti-inflammatory medications that inhibit the Janus Kinase-Signal transducer and activator of transcription pathway (JAK-STAT) show great promise in providing new and effective treatment of these formerly recalcitrant conditions. This brief review will cover inhibitors of the JAK-STAT pathway (JAK inhibitors) currently approved for use in treating dermatologic diseases including several very recently approved medications. It will also touch on additional conditions under study or where early reports of efficacy are promising.
Topics: Humans; Janus Kinase Inhibitors; Janus Kinases; STAT Transcription Factors; Signal Transduction; Skin Care
PubMed: 36860609
DOI: No ID Found -
Journal of Tissue Viability Nov 2020The non-invasive skin barrier measurements transepidermal water loss, stratum corneum hydration and the skin surface pH are widely used in clinical skin research....
BACKGROUND
The non-invasive skin barrier measurements transepidermal water loss, stratum corneum hydration and the skin surface pH are widely used in clinical skin research. Relative and absolute measurement errors of these measurements are unknown in geriatric care settings.
MATERIAL AND METHODS
Transepidermal water loss, stratum corneum hydration, skin surface pH and temperature were measured on the volar forearm and lower leg twice by trained raters within a cross-sectional study in ten nursing homes. Intrarater reliability was calculated using the ICC (1,1). Intrarater agreement was analyzed using Bland Altman Plots with limits of agreement.
RESULTS
Two hundred twenty-three residents were included and mean age was 84.2 years. The highest ICC was found for transepidermal water loss and skin surface temperature of the leg with 0.95 (95% CI 0.93 to 0.96). The ICC of the stratum corneum was 0.91 (95% CI 0.88 to 0.93) for both investigated skin areas. The measurement of the pH at the lower leg had the lowest ICC with 0.73 (95% CI 0.66 to 0.78). Highest limits of agreement of approximately 8 a.u. were calculated for stratum corneum hydration and lowest limits of agreement of approximately 1 °C were calculated for skin surface pH.
CONCLUSION
Relative measurement errors of transepidermal water loss and stratum corneum hydration were very low indicating that single measurements provide reliable estimates in this population and setting. However, the absolute measurement errors were high for both of these parameters. To increase reliability of skin surface pH we recommend at least two repeated measurements.
Topics: Aged; Aged, 80 and over; Architectural Accessibility; Body Mass Index; Cross-Sectional Studies; Female; Geriatrics; Germany; Humans; Male; Nursing Homes; Skin Care; Skin Temperature
PubMed: 32788086
DOI: 10.1016/j.jtv.2020.06.007 -
Maternal & Child Nutrition Oct 2021Women and their newborns are at risk of delayed or withheld skin-to-skin care (SSC) during a caesarean, which is about one-third of births, worldwide. To date, no...
Women and their newborns are at risk of delayed or withheld skin-to-skin care (SSC) during a caesarean, which is about one-third of births, worldwide. To date, no instrument exists to assess health professionals' (HPs) beliefs, and potential barriers and strategies for implementing SSC during a cesarean. The study aims were to (1) develop an instrument, Health Professionals' Beliefs about Skin-to-Skin Care During a Cesarean (SSC ), (2) establish its validity and reliability and (3) describe HPs' beliefs about SSC during a caesarean. Quantitative and qualitative analyses were used to test the SSC and describe HPs' beliefs. SSC analysis yielded a content validity of 0.83 and reliability of α = 0.9. We grouped all practice roles as either nurses or physicians. The mean rank score for nurses (n = 120, M = 90) was significantly higher (p = 0.001) than physicians (n = 46, M = 79). Despite this difference, scores for both roles reflected support for SSC. Participants identified hospital readiness to implement SSC and maintaining maternal and newborn safety as major issues. SSC is a valid, reliable instrument to measure HPs' beliefs about SSC during a caesarean birth. HPs can use the SSC during quality improvement initiatives to improve access to immediate SSC for women who have a caesarean birth. Improved access can enhance breastfeeding outcomes and promote optimal maternal and child health.
Topics: Breast Feeding; Cesarean Section; Child; Female; Humans; Infant, Newborn; Parturition; Pregnancy; Reproducibility of Results; Skin Care
PubMed: 34159712
DOI: 10.1111/mcn.13219 -
Skin Pharmacology and Physiology 2022Skin microbiome and skin physiology are important indicators of the epidermal homeostasis status. Stress models can reveal pathological conditions and modulating...
INTRODUCTION
Skin microbiome and skin physiology are important indicators of the epidermal homeostasis status. Stress models can reveal pathological conditions and modulating effects. Here we investigated the cutaneous microbiome in relation to skin physiology after mild tape stripping (TS) without treatment compared to two cosmetic leave-on lotions (pH 5.5 vs. pH 9.3) in 25 healthy volunteers.
METHODS
The microbiome was analyzed by 16S-rRNA-gene amplicon sequencing and put in relation to the following skin physiology parameter: epidermal barrier function (TEWA-Meter TM300), stratum corneum hydration (Corneometer CM 825), surface pH (pH-Meter), and skin erythema (Mexameter).
RESULTS
TS reduced the alpha diversity with a recovery over 7 days without treatment. Both lotions significantly accelerated the recovery of the alpha diversity already after 2 days with a slightly higher rate for the acidic lotion. After TS, the relative abundance of Proteobacteria was increased, whereas Actinobacteria were reduced. The relative abundances of typical skin-associated genera were reduced after TS. Taxa compositions returned to normal levels after 7 days in all treatment groups. An accelerated normalization could be observed with both lotions already after 2 days. A significant difference in skin pH was observed on day 2 and day 7 with an increased pH for the alkaline lotion. Both lotions induced an increase in stratum corneum hydration.
CONCLUSION
The study proved the suitability of an experimental stress model in the assessment of skin surface microbiome in relation to skin physiology. Stratum corneum hydration increased significantly with both lotions already at day 2. Microbiome parameters (alpha diversity, mean relative taxa, abundance of selected genera) normalized over 2-7 days. The following mechanisms could be responsible for the accelerated normalization of the microbiome: (a) optimized hydration during the recovery phase, (b) the composition of the lotion, (c) the induced repair mechanism. Thus, the formulation has a positive effect on the stratum corneum hydration and subsequently on cutaneous microbiome and skin physiology. Furthermore, this eventually has implications on the modulation of exogenous stress-induced epidermal alterations.
Topics: Emollients; Emulsions; Epidermis; Humans; Microbiota; Skin; Skin Care; Skin Physiological Phenomena
PubMed: 35908536
DOI: 10.1159/000526228 -
Advances in Skin & Wound Care Jun 2022To examine the effectiveness of a structured skin care protocol for preventing and treating incontinence-associated dermatitis (IAD) in critically ill patients.
OBJECTIVE
To examine the effectiveness of a structured skin care protocol for preventing and treating incontinence-associated dermatitis (IAD) in critically ill patients.
METHODS
Participants were drawn from the ICUs of three teaching hospitals between January 2016 and December 2017. Patients were eligible if they were ≥18 years old, had idiopathic fecal incontinence, had diarrhea but were unable to sense it, and were expected to stay in the ICU for at least 72 hours after developing incontinence. A total of 143 patients were enrolled: 79 in the experimental group and 64 in the control group. In the first phase of the study, routine skin care measures were used; in the second phase, three ICU caregivers were trained to provide a structured skin care protocol. Trained research team members conducted the data collection and analysis. The TREND (Transparent Reporting of Evaluations with Nonrandomized Designs) Statement Checklist was followed in reporting the study results.
RESULTS
Application of the structured skin care protocol reduced the incidence of IAD from 35.9% in the control phase to 17.7% in the intervention phase (χ2 = 6.117, P < .05) and also decreased the severity of IAD (z = -2.023, P < .05). Further, IAD developed later (z = -2.116, P < .05) in the intervention group than in the control group. In addition, the nursing times to prevent or manage IAD did not differ significantly between the groups (t = -0.258, P > .05; t = -1.190, P > .05).
CONCLUSIONS
Use of the developed structured skin care protocol for IAD in critically ill patients lowered the incidence and severity of IAD and delayed IAD development.
Topics: Adolescent; Critical Illness; Dermatitis; Fecal Incontinence; Humans; Intensive Care Units; Skin Care
PubMed: 35703853
DOI: 10.1097/01.ASW.0000828972.70137.8a