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Atlı N, Kaplan Serin E. Prevention and management of urinary incontinence-associated dermatitis: A systematic review. J Tissue Viability 2024:S0965-206X(24)00130-X. [PMID: 39223059 DOI: 10.1016/j.jtv.2024.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/05/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND To prevent incontinence-associated dermatitis (IAD) and manage the treatment, the cause of IAD must be determined correctly and distinguished from other skin problems. IAD can be prevented with professional care. AIM This systematic review aims to systematically examine the methods used in the prevention and treatment of urinary incontinence-associated dermatitis. MATERIALS AND METHODS The PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) criteria were taken as the basis for creating the systematic review protocol and writing the article. In this systematic review, the scans are combinations of words and word groups determined by the MeSH (Medical Subject Headings) terms "incontinence", "incontinence-associated dermatitis", "prevention of urinary incontinence", "treatment of urinary incontinence" and "randomized controlled". Studies conducted in the last eight years were examined in the PubMed, Cochrane Library, Web of Science, and Scopus databases between January and March 2024. Studies were selected by determining inclusion and exclusion criteria according to the PICOS method and these studies included in the review were evaluated according to the Joanna Briggs Institute (JBI) critical evaluation lists according to their types. RESULTS Five randomized controlled trials with a total of 644 participants were included in this systematic review. In all five studies included in the review, it was determined that pharmacological and non-pharmacological methods significantly reduced dermatitis associated with urinary incontinence. CONCLUSION In the reviewed studies, it was observed that pharmacological and non-pharmacological methods had a positive effect on dermatitis in individuals with IAD. It is recommended to conduct more studies of high methodological quality, using larger sample groups, with different interventions and randomization and blinding methods, and examining the effectiveness of pharmacological and non-pharmacological methods in individuals with urinary incontinence-associated dermatitis.
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Affiliation(s)
- Neslihan Atlı
- Sanlıurfa Training and Research Hospital, Pediatric Emergency Clinic, Sanlıurfa, 63250, Turkey.
| | - Emine Kaplan Serin
- Internal Medical Nursing Department, Nursing Faculty, Mersin University, Mersin, Turkey.
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Yüceler Kaçmaz H, Karadağ A, Akutay S, Çobanoğlu Aktan D. The Turkish version of the Skin Tear Knowledge Assessment Instrument (OASES): Validity and reliability study. Int Wound J 2024; 21:e70013. [PMID: 39087729 PMCID: PMC11292666 DOI: 10.1111/iwj.70013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/17/2024] [Accepted: 07/17/2024] [Indexed: 08/02/2024] Open
Abstract
This study was conducted to adapt the Skin Tear Knowledge Assessment Instrument (OASES) into Turkish and to verify its validity and reliability. This study was conducted on 314 nurses in Türkiye between November 2023 and February 2024 to test the psychometric properties of OASES. The instrument consists of 20 items clustered into six domains. The cultural adaptation process was carried out according to the International Testing Commission guidelines: Turkish translation, expert panel, content validity, translation back to English, preliminary study and the final version of the instrument. To check the validity of the multiple-choice test, item difficulty and discriminating index were analysed. The reliability of the instrument was evaluated to the retest 14 days after the first test. Scale level content validity by 11 experts in wound care was 0,97 (I-CVI = 0.8-1.0). In the item analysed of the OASES, the item difficulty index was 0,51 (p-value = 0.34-0.76) and the discriminating index was 0.40 (D-value = 0.26-0.51). The 2-week test-retest intraclass correlation coefficient of the overall instrument was 0.90 (95% CI = 0.79-0.95). The Turkish version of OASES is a valid and reliable measurement instrument to evaluate nurses' knowledge levels regarding skin tears with acceptable psychometric properties. It can be applied in nursing education, research and practice to evaluate the knowledge of Turkish speaking nurses about skin tears.
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Affiliation(s)
| | - Ayişe Karadağ
- Koc UniversityFaculty of Health Sciences, Department of NursingİstanbulTurkey
| | - Seda Akutay
- Erciyes UniversityFaculty of Health Sciences, Department of NursingKayseriTurkey
| | - Derya Çobanoğlu Aktan
- Hacettepe UniversityFaculty of Education, Department of Measurement and Evaluation in EducationAnkaraTurkey
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Qi L, Zhao Q, Guo L, Zhao B, Zhang M. Prevention and care for moisture-associated skin damage: A scoping review. J Tissue Viability 2024; 33:362-375. [PMID: 38906753 DOI: 10.1016/j.jtv.2024.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 03/14/2024] [Accepted: 06/05/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE Moisture-associated skin damage (MASD) is an inflammatory skin condition caused by long-term exposure to a moist environment, which can compromise the integrity of the barrier and increase pain. This scoping review aimed to systematically analyze the research status of prevention and care for MASD. METHODS We conducted a scoping review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, MEDLINE, Scopus, Web of Science, CINAHL, and the Cochrane Database of Systematic Reviews were searched for relevant articles until March 2023. RESULTS Based on eligibility criteria, 34 research studies and review articles were included. The prevalence of MASD varies greatly in different medical environments and patient groups. The high-risk factors included prolonged exposure to excessive water, chemical irritation such as urine or feces, mechanical factors such as friction or improper removal of medical adhesives and local bacterial colonization. Prevention measures mainly include avoiding skin exposure to moisture, skin cleansing, moisturizing and the treatment of secondary bacterial infection. CONCLUSION A variety of factors have an impact on MASD. Nurses should select suitable tools to screen high-risk patients and take targeted preventive measures according to the related types of skin injury to reduce the incidence of MASD.
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Affiliation(s)
- Lin Qi
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China; Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Qingsheng Zhao
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China; Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Lianrong Guo
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China; Qilu Hospital of Shandong University, Jinan, Shandong Province, China
| | - Bingnan Zhao
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong Province, China
| | - Min Zhang
- Qilu Hospital of Shandong University, Jinan, Shandong Province, China.
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Konya I, Yoshida M, Watanabe C, Morita A, Yano R. Effects of consecutive bed bathing with weak versus ordinary pressure on skin barrier recovery of hospitalised older adults: A within-person randomised controlled trial. J Tissue Viability 2024; 33:504-510. [PMID: 38816337 DOI: 10.1016/j.jtv.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 03/10/2024] [Accepted: 05/17/2024] [Indexed: 06/01/2024]
Abstract
AIM Wiping pressure (WP [mmHg]) during bed baths is essential to maintain skin integrity and care quality for older adults. However, effects of different wiping pressures on skin barrier recovery over multiple days remain unclear. This study evaluated and compared the effects of consecutive bed bathing with weak pressure and that with ordinary pressure on skin barrier recovery of hospitalised older adults. METHODS This within-person, randomised, controlled trial involved 254 forearms (127 patients) and was conducted at a general hospital. Forearms were blinded and randomly assigned a site and sequence of two bed bathing sessions: wiping three times with weak (10≤WP<20) and ordinary pressure (20≤WP<30) once per day for 2 consecutive days. The skin barrier was assessed daily based on transepidermal water loss (TEWL) and stratum corneum hydration (SCH) before and 15 min after the interventions. Dry skin was assessed using the overall dry skin score. RESULTS A linear mixed model showed that the time courses of TEWL and SCH differed significantly between groups. Impaired skin barrier function caused by ordinary pressure on the first day did not recover to baseline values the next day, whereas weak pressure did not cause significant changes. During subgroup analyses, TEWL of patients with dry skin was more likely to increase with ordinary pressure. CONCLUSIONS Despite decreased skin barrier recovery experienced by older adults, our findings suggest the safety of weak pressure and highlight the importance of WP during bed baths. Weak pressure is particularly desirable for patients with dry skin. TRIAL REGISTRATION UMIN000048838.
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Affiliation(s)
- Issei Konya
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan; Research Fellow of Japan Society for the Promotion of Science, Tokyo, Japan.
| | - Mayumi Yoshida
- Nursing Department, Yoichi Kyokai Hospital, Yoichi, Japan
| | | | - Akemi Morita
- Nursing Department, Yoichi Kyokai Hospital, Yoichi, Japan
| | - Rika Yano
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan.
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Liu X, Zhang Y, Hong Y, Zhang H. Global burden of fungal skin diseases: An update from the Global Burden of Diseases Study 2019. Mycoses 2024; 67:e13770. [PMID: 39054731 DOI: 10.1111/myc.13770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 07/09/2024] [Accepted: 07/12/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Fungal skin diseases are the most common and widespread fungal infections, exerting a significant impact on patients' socio-psychological health and the quality of life. OBJECTIVES To assess and compare the global burden of fungal skin diseases in 2019 and over the past 30 years. METHODS Data were retrieved from the Global Burden of Disease Study 2019. Incidence and years lived with disability (YLDs) were used to assess the burden of fungal skin diseases. A total of 204 countries and territories were hierarchically organised into 21 regions and seven super-regions. Data were presented as absolute numbers and rates per 100,000 population, stratified by sex, age, year and location. RESULTS In 2019, the global incidence rate and YLD rate of fungal skin diseases were 21,277 (95% UI 19 298-23,399) and 42 (95% UI 17-88) per 100,000 population, respectively. Sub-Saharan Africa bore the heaviest disease burden, especially children aged 5-9 years had a significantly higher incidence rate, YLD rate and YLDs to incidence ratio compared to other regions. Moreover, more than half of the incident cases among the elderly came from high-income regions and Southeast Asia, East Asia, and Oceania. Over the past 30 years, the number of incident cases and YLDs of fungal skin diseases has been continuously increasing worldwide, but the incidence rates and YLD rates have not shown significant changes. CONCLUSIONS The global burden of fungal skin diseases has been continuously rising. Children in Sub-Saharan Africa are experiencing higher disease incidence and severity compared to other regions.
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Affiliation(s)
- Xiaocong Liu
- Department of Dermatology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
- Institute of Mycology, Jinan University, Guangzhou, Guangdong, China
| | - Yishan Zhang
- Department of Dermatology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
- Institute of Mycology, Jinan University, Guangzhou, Guangdong, China
| | - Yujing Hong
- Department of Dermatology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
- Institute of Mycology, Jinan University, Guangzhou, Guangdong, China
| | - Hong Zhang
- Department of Dermatology, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
- Institute of Mycology, Jinan University, Guangzhou, Guangdong, China
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Amin R, Völzer B, El Genedy-Kalyoncu M, Blume-Peytavi U, Kottner J. Skin care types, frequencies and products: A cross-sectional study in German institutional long-term care. J Tissue Viability 2024; 33:318-323. [PMID: 38360494 DOI: 10.1016/j.jtv.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 01/26/2024] [Accepted: 02/09/2024] [Indexed: 02/17/2024]
Abstract
AIM The aim of the study was to describe types and frequencies of skin care interventions and products provided in institutional long-term care. MATERIALS AND METHODS Baseline data from a cluster randomized controlled trial conducted in nursing homes in Berlin, Germany was collected before randomization. Numbers, proportions and frequencies of washing, showering and bathing, and the application of leave-on products were calculated. Product labels were iteratively and inductively categorized into overarching terms and concepts. RESULTS A total of n = 314 residents participated in the study. In the majority, washing of the whole body was done once daily, and showering was performed once per week or more rarely. The majority received leave-on products daily on the face and once per week on the whole body. Most of the skin care interventions were delivered by nurses. There was marked heterogeneity in terms of product names, whereas the product names reveal little about the ingredients or composition. CONCLUSION Personal hygiene and cleansing interventions are major parts of clinical practice in long-term care. Daily washing is a standard practice at the moment. In contrast, leave-on products are used infrequently. To what extent the provided care promotes skin integrity is unclear. Due to the heterogeneity and partly misleading labels of skin care products, informed decision making is difficult to implement at present. CLINICALTRIALS GOV IDENTIFIER NCT03824886.
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Affiliation(s)
- Ruhul Amin
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117, Berlin, Germany; BCSIR Laboratories Dhaka, Bangladesh Council of Scientific and Industrial Research, Dhaka, Bangladesh
| | - Bettina Völzer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117, Berlin, Germany
| | - Monira El Genedy-Kalyoncu
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117, Berlin, Germany
| | - Ulrike Blume-Peytavi
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117, Berlin, Germany
| | - Jan Kottner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117, Berlin, Germany.
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Ximenes RRC, Chaves EMC, Girão ALA, Gonçalves MHRB, Ferreira SL, de Carvalho REFL. Knowledge of nursing staff before and after training on incontinence-associated dermatitis. Rev Esc Enferm USP 2024; 58:e20230272. [PMID: 38558025 PMCID: PMC11021019 DOI: 10.1590/1980-220x-reeusp-2023-0272en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/31/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE To verify the knowledge of nursing staff before and after training on incontinence-associated dermatitis. METHOD A study before and after an educational intervention carried out with nursing staff from the medical and surgical clinics and intensive care unit of the university hospital in June 2023. The training took place over three meetings. Data was collected using a questionnaire administered immediately before and after the training. McNemar's test for dependent samples was used to compare before and after training. RESULTS 25 nurses and 14 nursing technicians took part. The items that showed statistical significance were related to the identification and correct differentiation of dermatitis associated with incontinence and pressure injury; and the correct way to sanitize the skin. CONCLUSION The training of the nursing team made it possible to assess their knowledge of how to identify, prevent and treat incontinence-associated dermatitis.
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Affiliation(s)
- Raelly Ramos Campos Ximenes
- Universidade Estadual do Ceará, Programa de Pós-Graduação em Cuidados Clínicos em Enfermagem e Saúde, Fortaleza, CE, Brazil
| | - Edna Maria Camelo Chaves
- Universidade Estadual do Ceará, Programa de Pós-Graduação em Cuidados Clínicos em Enfermagem e Saúde, Fortaleza, CE, Brazil
| | | | | | - Saionara Leal Ferreira
- Universidade Federal do Ceará, Hospital Universitário Walter Cantídio, Fortaleza, CE, Brazil
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Franco-Gil ME, Graça A, Martins A, Marto J, Ribeiro HM. Emollients in dermatological creams: Early evaluation for tailoring formulation and therapeutic performance. Int J Pharm 2024; 653:123825. [PMID: 38253270 DOI: 10.1016/j.ijpharm.2024.123825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/26/2023] [Accepted: 01/19/2024] [Indexed: 01/24/2024]
Abstract
The targeted choice of the emollient of a cream determines its physicochemical properties and clinical effectiveness. This work researched the effects of emollient properties on the final characteristics and potential performance of oil-in-water dermatological creams. Seven emollients with different chemical characteristics and structures (alkane, triglyceride, ether, silicone, vegetable oils, and mineral oil) were tested in a model formulation. Early stability, pH, droplet size distribution, rheology, tackiness, adhesivity, spreadability, tribology, and release profile of a lipophilic substance model (in Franz cells, through a synthetic membrane, for six hours) were assessed. The creams had acid epicutaneous pH and a "shear-thinning" "solid-like" viscoelastic behavior. Among the seven emollients' properties, polarity, density, and viscosity were the most influential. Droplet parameters were the most impacted, pH and release were moderately affected, and the textural properties were lowly to moderately impacted. The emollient substitution in the model formulation affected the experimental parameters differently, allowing formulation optimization and tailoring its potential therapeutic performance regarding drug release, coadjutant effects, and dwell time on the skin. By looking at the creams' characteristics, it was possible to select the best-suited emollients for releasing a lipophilic drug, applying on painful skin, and formulation in wash-off products or leave-on protective barrier creams.
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Affiliation(s)
- M E Franco-Gil
- Research Institute for Medicines (iMed.UL), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto S/N, 1649-003 Lisboa, Portugal; Department of Pharmaceutics and Food Technology, Faculty of Pharmacy, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, Ciudad Universitaria, 28040 Madrid, Spain; University Institute of Industrial Pharmacy (IUFI), Faculty of Pharmacy, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n, Ciudad Universitaria, 28040 Madrid, Spain.
| | - A Graça
- Research Institute for Medicines (iMed.UL), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto S/N, 1649-003 Lisboa, Portugal.
| | - A Martins
- Research Institute for Medicines (iMed.UL), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto S/N, 1649-003 Lisboa, Portugal.
| | - J Marto
- Research Institute for Medicines (iMed.UL), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto S/N, 1649-003 Lisboa, Portugal.
| | - H M Ribeiro
- Research Institute for Medicines (iMed.UL), Faculty of Pharmacy, Universidade de Lisboa, Avenida Prof. Gama Pinto S/N, 1649-003 Lisboa, Portugal.
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Amin R, Rancan F, Hillmann K, Blume‐Peytavi U, Vogt A, Kottner J. Effects of a leave-on product on the strength of the dermoepidermal junction: An exploratory, intraindividual, randomized controlled trial in older adults with dry skin. Health Sci Rep 2024; 7:e1985. [PMID: 38505682 PMCID: PMC10949320 DOI: 10.1002/hsr2.1985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/08/2024] [Accepted: 03/03/2024] [Indexed: 03/21/2024] Open
Abstract
Background and Aims Skin aging is associated with dry skin and a decrease of the strength of the dermoepidermal adhesion, which increases the risk for lacerations (skin tears). Application of leave-on products improves dry skin and seems to reduce skin tear incidence. The aim of this study was to measure the effects of a humectant containing leave-on product on the strength of the dermoepidermal junction in older adult participants with dry skin. Methods A randomized controlled trial using a split body design was conducted. One forearm was randomly selected and treated with a lipophilic leave-on product containing 5% urea for 8 weeks. The other forearm was the control. The parameters stratum corneum hydration (SCH), transepidermal water loss, pH, roughness, epidermal thickness and skin stiffness were measured at the baseline, Weeks 4 and 8. At Week 8, suction blisters were created and time to blistering was measured. Blister roofs and interstitial fluid were analyzed for Interleukin-1α, 6 and 8. Results Twelve participants were included. After 8 weeks treatment, SCH was higher (median difference 11.6 AU), and the overall dry skin score (median difference -1) and median roughness (Rz difference -12.2 µm) were lower compared to the control arms. The median group difference for Interleukin-1α was -452 fg/µg total protein (TP) in the blister roofs and -2.2 fg/µg TP in the blister fluids. The median time to blister formation was 7.7 min higher compared to the control arms. Conclusion The regular application of humectant containing leave-on products improves dry skin and seems to lower inflammation and contribute to the strengthening of the dermoepidermal adhesion. This partly explains how the use of topical leave-on products helps to prevent skin tears.
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Affiliation(s)
- Ruhul Amin
- Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, Charité—Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
- BCSIR Laboratories DhakaBangladesh Council of Scientific and Industrial ResearchDhakaBangladesh
| | - Fiorenza Rancan
- Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, Charité—Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Kathrin Hillmann
- Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, Charité—Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Ulrike Blume‐Peytavi
- Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, Charité—Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Annika Vogt
- Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, Charité—Universitätsmedizin Berlincorporate member of Freie Universität Berlin and Humboldt‐Universität zu BerlinBerlinGermany
| | - Jan Kottner
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1BerlinGermany
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Jakubczyk K, Nowak A, Muzykiewicz-Szymańska A, Kucharski Ł, Szymczykowska K, Janda-Milczarek K. Kombucha as a Potential Active Ingredient in Cosmetics-An Ex Vivo Skin Permeation Study. Molecules 2024; 29:1018. [PMID: 38474530 DOI: 10.3390/molecules29051018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/22/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
Kombucha is a non-alcoholic beverage, that is increasingly used in the cosmetic industry. The available literature reports the positive effects of kombucha on the skin, in particular its antioxidant action. However, there is a lack of information on skin permeation and the accumulation of active ingredients showing such effects. Skin aging is largely dependent on oxidative stress, therefore in our study we assessed the ex vivo permeation of two types of kombucha (green and black tea) through porcine skin. The antioxidant activity (DPPH, ABTS, FRAP methods) and total polyphenol content of these extracts were determined before and after permeation testing. Moreover, the content of selected phenolic acids as well as caffeine was assessed. Skin permeation was determined using a Franz diffusion cell. The antioxidant activity of both Kombuchas was found to be high. In addition, gallic acid, chlorogenic acid, protocatechuic acid, coumaric acid, m-hydroxybenzoic acid, and caffeine were identified. A 24-h ex vivo study showed the permeation of some phenolic acids and caffeine and their accumulation in the skin. Our results confirm the importance of studying the skin permeation of what are still little known ingredients in cosmetic preparations. Evaluation of the accumulation of these ingredients can guarantee the efficacy of such preparations.
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Affiliation(s)
- Karolina Jakubczyk
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 24 Broniewskiego Street, 71-460 Szczecin, Poland
| | - Anna Nowak
- Chair and Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich Ave. 72, 70-111 Szczecin, Poland
| | - Anna Muzykiewicz-Szymańska
- Chair and Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich Ave. 72, 70-111 Szczecin, Poland
| | - Łukasz Kucharski
- Chair and Department of Cosmetic and Pharmaceutical Chemistry, Pomeranian Medical University in Szczecin, Powstańców Wielkopolskich Ave. 72, 70-111 Szczecin, Poland
| | - Kinga Szymczykowska
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 24 Broniewskiego Street, 71-460 Szczecin, Poland
| | - Katarzyna Janda-Milczarek
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 24 Broniewskiego Street, 71-460 Szczecin, Poland
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Ramos MCM, Velasco MVR, Bueno M, Veríssimo MDLÓR. Effects of Liquid and Bar Soaps on the Skin of Brazilian Newborns: A Randomized Controlled Trial. Skin Pharmacol Physiol 2024; 36:267-277. [PMID: 38262395 DOI: 10.1159/000536066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/21/2023] [Indexed: 01/25/2024]
Abstract
INTRODUCTION Compared to adults, newborns' skin has a thinner epidermis and stratum corneum with decreased hydration levels, higher transepidermal water loss, and a pH variation between 5.5 and 7.5. These characteristics can predispose to the occurrence of dryness, infections, and dermatological conditions. Water and liquid soap with adequate formulation have shown to be beneficial and safe for newborns' skin. However, studies evaluating the effect of bar soap, products widely used in Brazil and Latin America, are unknown. Therefore, the objective of this study was to compare the effects of liquid and bar soaps on the term newborns' skin. METHODS This randomized controlled, parallel, single-blind clinical trial was conducted at a public university hospital in São Paulo, Brazil. 100 healthy term newborns with no congenital anomalies, acute diseases, or dermatological conditions were randomized to use liquid soap (experimental group) or bar soap (control group). Skin pH, transepidermal water loss, stratum corneum hydration, sebum content, and skin condition were assessed before and after the first bath, at 48 h, 14 days, and 28 days after birth. These evaluations were performed on the forearm, abdomen, buttocks, and thigh. In addition, the mother's perception of soap use was also evaluated. RESULTS Data of 100 newborns were analyzed by intention to treat. The rate of retention was 53%. Newborns exposed to the liquid soap presented significantly better skin acidification (p < 0.001) and significantly better stratum corneum hydration (p < 0.001) than the skin of newborns exposed to the bar soap, regardless of the area evaluated. There were no significant differences in transepidermal water loss, sebum content, dryness, erythema, or skin breakdown and the mother's perceptions of the use of the soaps. CONCLUSION Newborns in the experimental group presented better skin acidification and stratum corneum hydration when compared to newborns in the control group.
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Affiliation(s)
| | | | - Mariana Bueno
- Peter Gilgan Centre For Research and Learning (PGCRL), Hospital For Sick Children Foundation, Toronto, Ontario, Canada
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12
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Völzer B, El Genedy-Kalyoncu M, Fastner A, Tomova-Simitchieva T, Neumann K, Hillmann K, Blume-Peytavi U, Hahnel E, Sill J, Balzer K, Kottner J. Enhancing skin health and safety in aged care (SKINCARE trial): A cluster-randomised pragmatic trial. Int J Nurs Stud 2024; 149:104627. [PMID: 37956524 DOI: 10.1016/j.ijnurstu.2023.104627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Older nursing home residents are prone to develop different skin conditions at the same time, including xerosis cutis, skin tears, pressure ulcers, incontinence-associated dermatitis or intertrigo. Guidelines and recommendations mainly address these skin conditions separately. The overall aim of this study was to measure the effects of the implementation of a skincare and prevention package. TRIAL DESIGN A two-arm cluster-randomised controlled trial was conducted. METHODS In nursing homes being assigned to the intervention group, an evidence-based and structured skincare and prevention programme was implemented for six months. Nursing home residents in the control group received standard care as usual. Blinded dermatologists conducted head-to-toe skin assessments, and the researchers assessed skin barrier parameters including stratum corneum hydration and transepidermal water loss at the upper and lower extremities after three and six months. Outcomes included the cumulative incidence of incontinence-associated dermatitis, skin tears, pressure ulcers and intertrigo, and were presented as intention-to-treat and per protocol analysis. Skin dryness and resident-reported outcomes (pain, itch, quality of life) were assessed. RESULTS A random sample of 17 nursing homes in the federal state of Berlin, Germany, was drawn and randomised in intervention (n = 9) and control groups (n = 8). In total, 165 participants were allocated to the intervention, and 149 participants were allocated to the control group. The cumulative incidence of skin tears (19.2 %, 95 % CI 12.8-27.8), pressure ulcers (13.6 %, 95 % CI 8.1-21.9) and intertrigo (27.0 %, 95 % CI 18.4-37.7) was lower in the intervention compared to the control group, with cumulative incidences of 27.2 % (95 % CI 19.3-36.9) for skin tears, 16.9 % (95 % CI 10.6-25.9) for pressure ulcer, and 37.8 % (95 % CI 27.5-49.4) for intertrigo. The incidence of incontinence-associated dermatitis was higher in the intervention group (26.3 %, 95 % CI 17.9-36.8) compared to the control group (23.1 %; 95 % CI 14.6-34.5). Mean skin dryness was lower in the intervention group but showed variation. The impact on pain, itch, and quality of life was trivial. CONCLUSIONS The present study results indicate that the implementation of tailored and evidence-based nursing routines improves skin health and safety in residential long-term care. Evidence suggests that multiple adverse skin conditions can be prevented by regular skin assessments and individually tailored skincare routines. Positive effects on skin dryness were observed, but skin physiology parameters did not indicate changes of the skin barrier function. TRIAL REGISTRATION This study is registered at the German Clinical Trials Register (registration number: DRKS00015680; date of registration: January 29th, 2019) and ClinicalTrials.gov (NCT03824886; date of registration: January 31st, 2019).
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Affiliation(s)
- Bettina Völzer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Monira El Genedy-Kalyoncu
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Alexandra Fastner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Tsenka Tomova-Simitchieva
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117 Berlin, Germany
| | - Konrad Neumann
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Biometry and Clinical Epidemiology, Charitéplatz 1, 10117 Berlin, Germany
| | - Kathrin Hillmann
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117 Berlin, Germany
| | - Ulrike Blume-Peytavi
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117 Berlin, Germany
| | - Elisabeth Hahnel
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Charitéplatz 1, 10117 Berlin, Germany
| | - Janna Sill
- University of Lübeck, Nursing Research Unit, Institute for Social Medicine and Epidemiology, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Katrin Balzer
- University of Lübeck, Nursing Research Unit, Institute for Social Medicine and Epidemiology, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Jan Kottner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany; Ghent University, Faculty of Medicine and Health Sciences, Belgium.
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Cortés OL, Herrera VM, Salazar LD, Rojas YA, Esparza M, Taborda A, Dennis RJ. Impact of hydrocolloid dressings in the prevention of pressure ulcers in high-risk patients: a randomized controlled trial (PENFUP). Sci Rep 2023; 13:21639. [PMID: 38062132 PMCID: PMC10703794 DOI: 10.1038/s41598-023-47483-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
It is uncertain whether hydrocolloid dressings, a more costly intervention than offering standard care with petrolatum, is superior to prevent pressure ulcers among hospitalized high-risk adults. Randomized, parallel-group, open-label, superiority trial with an active control group, blinded for investigators, event validators, and analysts (December 1, 2015 to December 12, 2017). Eligible patients were ≥ 18 years of age with intact skin judged as high-risk for skin ulcers (Braden scale), admitted to surgical or medical wards of two tertiary-level hospitals. Participants were randomized (1:1) to protection with hydrocolloid dressings or petrolatum. The primary outcome was the first occurrence of pressure ulcers (with post-injury photographs adjudicated by three judges) under intention-to-treat analysis. Based on prior cost analysis, and the available resources (assumed incidence of 6 ulcers/1000 patient-days in controls), inclusion of up to 1500 participants allowed to surpass a one-sided superiority threshold > 5% based on a target efficacy > 40% for dressings. We planned an economic analysis using a decision tree model based on the effectiveness of the study results from a perspective of the third payer of health care. After inclusion of 689 patients (69 events), the trial was stopped for futility after a planned interim analysis (conditional power < 0.1 for all scenarios if the trial was completed). Pressure ulcers had occurred in 34 (10.2%) patients in the intervention group [9.6 per 1000 patient-days] and 35 (9.9%) participants in the control group [7.9 per 1000 patient-days], HR = 1.07 [95% CI 0.67 to 1.71]. The estimated incremental cost for dressings (a dominated strategy) was USD 52.11 per patient. Using hydrocolloid dressings was found similar to petrolatum for preventing pressure ulcers among hospitalized high-risk patients. As it conveys additional costs, and in this study was unlikely to demonstrate enough superiority, this strategy did not overcome conventional skin care.Trial registration: ClinicalTrials.gov identifier (NCT number): NCT02565745 registered on December 1, 2015.
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Affiliation(s)
- Olga L Cortés
- Research Department, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia.
- Nursing Department, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia.
| | | | - Luz D Salazar
- Hospitalization Services, Fundación Cardioinfantil-Instituto Cardiología, Bogotá, Colombia
| | - Yudy A Rojas
- Nursing Department, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia
| | - Maribel Esparza
- Nursing Department, Clínica Carlos Ardila Lulle, FOSCAL, Bucaramanga, Colombia
| | - Alejandra Taborda
- Department of Public Health and Health Economics, Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia
| | - Rodolfo José Dennis
- Research Department, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, Colombia
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Amin R, Völzer B, Genedy-Kalyoncu ME, Blume-Peytavi U, Kottner J. The prevalence and severity of dry skin and related skin care in older adult residents in institutional long-term care: A cross-sectional study. Geriatr Nurs 2023; 54:331-340. [PMID: 37950968 DOI: 10.1016/j.gerinurse.2023.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/13/2023]
Abstract
OBJECTIVES To identify possible factors associated with different severities of xerosis cutis and to describe possible associations between (skin) care dependency and application of moisturizers. DESIGN Cross-sectional study using baseline data from a cluster-randomized controlled trial. Demographic and health characteristics, skin physiological measurements, functional abilities and application of moisturizers were compared between the participants with mild and severe dry skin. Frequency of moisturization were also compared based on the participants' skin care dependency. RESULTS The more distal the body area, the more severe xerosis were observed. There were no or minor differences between the groups, except for the stratum corneum hydration and skin surface pH. Participants with severe xerosis received moisturizers less often. Skin care dependent residents received moisturizers frequently. CONCLUSION There is under-application regarding xerosis cutis treatment in long-term care. Skin care provided by nurses, in adequate frequencies, might be helpful compared to skin care performed by the residents themselves.
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Affiliation(s)
- Ruhul Amin
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117 Berlin, Germany; BCSIR Laboratories Dhaka, Bangladesh Council of Scientific and Industrial Research, Dhaka, Bangladesh
| | - Bettina Völzer
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Monira El Genedy-Kalyoncu
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Ulrike Blume-Peytavi
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Jan Kottner
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany.
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15
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Abiakam NS, Jayabal H, Abbas S, Filingeri D, Bader DL, Worsley PR. The Effects of Incontinence Pad Application on Loaded Skin With Reference to Biophysical and Biochemical Parameters: An Exploratory Cohort Study Using a Repeated-Measures Design. J Wound Ostomy Continence Nurs 2023; 50:512-520. [PMID: 37966081 DOI: 10.1097/won.0000000000001032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
PURPOSE The purpose of this study was to evaluate temporal changes in skin responses following exposure to moisture alone or moisture in combination with mechanical loading. DESIGN Comparison cohort with a repeated-measures design. SUBJECTS AND SETTINGS The sample comprised 12 healthy volunteers. Participants were purposely sampled from 2 different age groups; half were 32 to 39 years old and half were 50 to 62 years old. Participants identified as White, Black, or mixed; 83% (n = 10) identified as White; 8 (67%) were female. METHODS Four sites at the sacrum were challenged with the application of specimens taken from 2 absorbent products; the pad specimens were applied dry or saturated with synthetic urine (SU; pH = 8); a further site from the sacral skin was also selected and used as a control. Skin assessments were performed at different points in time: (1) 60 minutes after exposure to dry or SU-saturated pad specimens; (2) 60 minutes after exposure to pads and mechanical loading (application of pressure in the form of 45°C high sitting); and (3) 30 minutes after removal of all pads (recovery period). Outcome measures were transepidermal water loss (TEWL), stratum corneum (SC) hydration, erythema, pH, and skin inflammatory biomarkers measured at each of the time points described earlier. RESULTS The control site and those exposed to dry pads showed minimal time-dependent changes irrespective of the parameter investigated. In contrast, significant increases in TEWL (P = .0000007) and SC hydration responses (P = .0000007) were detected at the sites under absorbent pad specimens after saturation with SU (exposure to moisture). In some participants, TEWL and SC hydration parameters were significantly higher during pressure application. Skin pH remained in the mildly acidic range throughout the test session, and no consistent trends were observed with erythema. Skin inflammatory biomarkers also exhibited considerable variability across participants; none changed significantly over time. Significant differences (P = .02) were also detected following the exposure of moisture in combination with pressure. CONCLUSION We evaluated an array of parameters to identify changes following skin exposure to 2 absorbent pads in the presence and absence of SU and mechanical loading. Analysis revealed changes in skin barrier properties in the presence of moisture and/or pressure. This observation suggests a need for frequent pad changing as well as periods of skin off-loading to protect the skin health of individuals with incontinence.
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Affiliation(s)
- Nkemjika S Abiakam
- Nkemjika S. Abiakam, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Hemalatha Jayabal, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Shabira Abbas, PhD, Essity AB, Gothenburg, Sweden
- Davide Filingeri, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Dan L. Bader, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Peter R. Worsley, DSc, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Hemalatha Jayabal
- Nkemjika S. Abiakam, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Hemalatha Jayabal, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Shabira Abbas, PhD, Essity AB, Gothenburg, Sweden
- Davide Filingeri, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Dan L. Bader, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Peter R. Worsley, DSc, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Shabira Abbas
- Nkemjika S. Abiakam, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Hemalatha Jayabal, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Shabira Abbas, PhD, Essity AB, Gothenburg, Sweden
- Davide Filingeri, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Dan L. Bader, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Peter R. Worsley, DSc, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Davide Filingeri
- Nkemjika S. Abiakam, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Hemalatha Jayabal, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Shabira Abbas, PhD, Essity AB, Gothenburg, Sweden
- Davide Filingeri, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Dan L. Bader, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Peter R. Worsley, DSc, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Dan L Bader
- Nkemjika S. Abiakam, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Hemalatha Jayabal, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Shabira Abbas, PhD, Essity AB, Gothenburg, Sweden
- Davide Filingeri, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Dan L. Bader, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Peter R. Worsley, DSc, School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Peter R Worsley
- Nkemjika S. Abiakam, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Hemalatha Jayabal, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Shabira Abbas, PhD, Essity AB, Gothenburg, Sweden
- Davide Filingeri, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Dan L. Bader, PhD, School of Health Sciences, University of Southampton, Southampton, United Kingdom
- Peter R. Worsley, DSc, School of Health Sciences, University of Southampton, Southampton, United Kingdom
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16
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Yao D, Gong X, Ma Y, Gong T, Wang G. The prevalence and interventions of xerosis cutis among older adults: A systematic review and meta-analysis. Geriatr Nurs 2023; 54:219-228. [PMID: 37844538 DOI: 10.1016/j.gerinurse.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/22/2023] [Accepted: 09/26/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Xerosis cutis in older adults is a geriatric public health issue that severely affects healthy aging, associated with adverse outcomes and increased nursing burden. Skin care plays a significant role in the management of xerosis cutis. AIM To assess the pooled prevalence and interventions of xerosis cutis among older adults. METHODS We searched ten databases systematically from inception to August 29, 2023. We estimated pooled prevalence of xerosis cutis using Stata 15.0. RESULTS 28 articles were included in this review. The pooled prevalence of xerosis cutis was 53 %(95 %CI:36-69 %). We found the prevalence of xerosis cutis was highest in nursing homes and developed countries. The prevalence of xerosis cutis was similar in males and females. The prevalence of mild xerosis cutis and xerosis cutis at lower limbs was relatively high. Regular use of humectant-containing leave-on skin care products and structured skin care regimens were helpful in alleviating xerosis cutis. CONCLUSION Older adults are at high risk for xerosis cutis. The research provides health professionals with a basic framework for the prevention and management of xerosis cutis.
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Affiliation(s)
- Dan Yao
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province 611137, China
| | - Xiaoyan Gong
- College of Nursing, Chengdu University of Traditional Chinese Medicine, No.1166 Liutai Road, Wenjiang District, Chengdu City, Sichuan province 611137, China
| | - Yao Ma
- School of Medicine, University of Electronic Science and Technology of China, No.4, Section 2, Jianshe north Road, Chenghua District, Chengdu City, Sichuan province 610054, China
| | - Ting Gong
- Department of Nursing, Chengdu second people's hospital, No. 10, Qingyun South Street, Jinjiang District, Chengdu City, Sichuan province 610017, China
| | - Guorong Wang
- Department of Nursing, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Cancer Hospital affiliate to University of Electronic Science and Technology of China, No. 55, Section 4, Renmin south Road, Wuhou District, Chengdu City, Sichuan province 610042, China.
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Therstappen K, Eichner A, Wohlrab J. [Practical problems with the use of topicals in geriatric dermatology]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:773-781. [PMID: 37493717 PMCID: PMC10516777 DOI: 10.1007/s00105-023-05187-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 07/27/2023]
Abstract
Changes related to aging affect all layers of the skin and are influenced by both intrinsic conditions and extrinsic factors. The extent of the senescent changes can vary enormeously in seniors, so that an individual assessment is useful and often necessary. Of particular clinical importance are changes in the epidermis, which entail a complex reduction of the barrier function and a reduction in the compensatory capacity with regard to exogenous noxae. This results in increased susceptibility, especially toward infection and cancer. Against this background, a prophylactic strategy for the substitution of the physicochemical and thus also the microbiological barrier in the context of basic care is very important. In order to be able to implement these consistently, recommendations for preparations explicitly designed for aging skin as well as practical instructions for use are highly meaningful. The latter should take into account limitations regarding mobility as well as possible cognitive deficits of seniors. For this purpose, creams and suitable preparations in terms of viscosity and composition should be recommended. In order to facilitate implementation, written or pictorial recommendations for application as well as digital assistance systems can be used. Due to demographic developments in Germany and Europe, the clinical relevance of geriatric dermatology will significantly increase in the future.
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Affiliation(s)
- K Therstappen
- Universitätsklinik und Poliklinik für Dermatologie und Venerologie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland
| | - A Eichner
- Universitätsklinik und Poliklinik für Dermatologie und Venerologie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland.
- An-Institut für angewandte Dermatopharmazie (IADP), Martin-Luther-Universität Halle-Wittenberg, Weinbergweg 23, 06120, Halle (Saale), Deutschland.
| | - J Wohlrab
- Universitätsklinik und Poliklinik für Dermatologie und Venerologie, Martin-Luther-Universität Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle (Saale), Deutschland
- An-Institut für angewandte Dermatopharmazie (IADP), Martin-Luther-Universität Halle-Wittenberg, Weinbergweg 23, 06120, Halle (Saale), Deutschland
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18
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Yüceler Kaçmaz H, Kaplan Ö, Kaplan A, Şahin MG, Cetinkaya A, Avci A. Incontinence-Associated Dermatitis: Prevalence in Intensive Care Units and Knowledge, Attitudes, and Practices of Nurses. J Nurs Care Qual 2023; 38:354-360. [PMID: 36947830 DOI: 10.1097/ncq.0000000000000707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Incontinence-associated dermatitis (IAD) is a major concern among hospitals, especially in intensive care units (ICUs). PURPOSE To describe ICU nurses' knowledge, attitudes, and practices of IAD and to examine the relationships with IAD prevalence in the ICU setting. METHODS A descriptive correlational design was used including the Knowledge, Attitudes and Practices of Incontinence-Associated Dermatitis Questionnaire and 1-month IAD prevalence data. RESULTS The prevalence of IAD in ICUs was 6.89%. A positive correlation was found between IAD prevalence and nurses' IAD knowledge and attitudes. Nurses working in the ICU for more than 7 years, caring for patients at high risk for or having IAD, and thinking IAD-related nursing practices were sufficient had significantly higher IAD knowledge, attitudes, and practices. CONCLUSIONS Findings indicate that ICU nurses learned about IAD through clinical experience and have inadequate training on IAD. A standardized evidence-based care protocol for IAD should be developed.
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Affiliation(s)
- Hatice Yüceler Kaçmaz
- Department of Nursing, Health Science Faculty, Erciyes University, Kayseri, Turkey (Drs Yüceler Kaçmaz and Özlem Kaplan); First and Emergency Aid Program, İncesu Ayşe and Saffet Arslan Health Services Vocational School, University of Kayseri, Kayseri, Turkey (Dr Ali Kaplan); Department of Women's Health Nursing, Erciyes University, Kayseri, Turkey (Ms Şahin); Ministry of Health, Kayseri City Hospital, Kayseri, Turkey (Ms Şahin); and Departments of Internal Medicine (Mr Cetinkaya) and Dermatology (Mr Avci), Health Science University Kayseri City Hospital, Kayseri, Turkey
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Tasdogan A, Moelleken M, Dissemond J. [Eczema of wound surroundings : Genesis, diagnostics and treatment]. Z Gerontol Geriatr 2023; 56:505-515. [PMID: 37642727 DOI: 10.1007/s00391-023-02222-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 05/10/2023] [Indexed: 08/31/2023]
Abstract
Skin changes in the surrounding areas of wounds are a frequently occurring multidisciplinary challenge in the care of patients with wounds, especially in older people. These are often inflammatory skin diseases like eczema that can be caused by various factors. These include allergens, noxa, incorrect skin care or prolonged contact with moisture. In the diagnostics, detailed medical history, clinical examination and allergological tests play important roles. Eczema can mostly be treated symptomatically with topical glucocorticoids. Calcineurin inhibitors are an alternative treatment, especially for longer term topical applications. In cases of impetiginized lesions, appropriate antimicrobial therapy should also be carried out. For long-term and preventive treatment the adequate use of skin care and skin protection products that help to strengthen or restore the skin barrier is decisive as well as the education of the patients and, if necessary, their relatives.
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Affiliation(s)
- Alpaslan Tasdogan
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland
| | - Maurice Moelleken
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland
| | - Joachim Dissemond
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland.
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Kottner J. Nurses as skin care experts: Do we have the evidence to support practice? Int J Nurs Stud 2023; 145:104534. [PMID: 37348391 DOI: 10.1016/j.ijnurstu.2023.104534] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/20/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Jan Kottner
- Charité-Universitätsmedizin Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany.
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21
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Aoki M, Hata N, Yotsuya J. Effectiveness of Three Types of Moisturizers on Senile Dry Skin: A Randomized Controlled Pilot Trial. Dermatol Res Pract 2023; 2023:1809109. [PMID: 37520456 PMCID: PMC10374378 DOI: 10.1155/2023/1809109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 06/15/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023] Open
Abstract
Background For dry skin, the application of a hypoallergenic moisturizer twice daily is recommended in elderly individuals. However, it is not known which is the most effective and appropriate moisturizer among the commercially available moisturizers. Aims In this study, we aimed to investigate the efficacy of the three widely used moisturizers for the treatment of senile dry skin. Patients/Methods. This interventional study involved elderly individuals aged >65 years who were living in a nursing home. The participants were randomly divided into the interventional (moisturizers A, B, and C) and conventional care groups. Moisturizers A, B, and C were applied on the skin of each member of the three intervention groups twice daily for 8 weeks. The water content of the stratum corneum and transepidermal water loss (TEWL) were evaluated before and after the intervention. Changes in these parameters among the groups were compared using two-way analysis of variance and a posthoc test. Results Moisturizers A, B, and C and conventional care groups comprised six, seven, five, and four participants, respectively. The water content of the stratum corneum was significantly higher in the moisturizer A (p = 0.01) and B (p = 0.047) groups than in the conventional care group. There was no significant difference in TEWL among the groups. Conclusions In terms of the appearance of the skin, white powder and small scales were both reduced in group A. Taken together with the water content, this was considered a clinically significant change.
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Affiliation(s)
- Miku Aoki
- Division of Nursing, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
| | - Natsuki Hata
- Department of Nursing, Graduate School of Medical Sciences, University of Fukui, Fukui, Japan
| | - Junko Yotsuya
- Division of Nursing, Faculty of Medical Sciences, University of Fukui, Fukui, Japan
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22
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Kottner J, Fastner A, Lintzeri DA, Griffiths CEM, Blume-Peytavi U. Improving skin health of community-dwelling older people: a scoping review protocol. BMJ Open 2023; 13:e071313. [PMID: 37221019 DOI: 10.1136/bmjopen-2022-071313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
INTRODUCTION Ageing is accompanied by an age-related decrease in mobility or cognitive and sensory functions; in addition, physiological changes in the skin occur with age. Therefore, the skin requires appropriate care and observation in order to prevent or manage a variety of dermatological diseases and conditions, and to prevent or minimise effects on the quality of life.Globally, most older people live at home, and the need to establish sustainable structures and processes to support and to care for people at home for as long as possible has been emphasised. The body of evidence supporting screening, diagnosis and management of skin conditions in older people living at home has not been collated and summarised to date. The aim of this scoping review is to describe and summarise the extent and nature of the available body of evidence in this regard. METHODS AND ANALYSIS This scoping review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Eligibility criteria were developed using the Population, Concept and Context framework, and the search will focus on systematic and scoping reviews as well as clinical practice guidelines. Two reviewers will conduct systematic searches, screen and select identified evidence as well as extract and chart data, independently. Finally, data will be systematically analysed and summarised descriptively to map existing evidence and identify gaps. ETHICS AND DISSEMINATION Due to the nature of research, not involving humans or unpublished secondary data, approval of an ethics committee is not required. The dissemination of findings is planned via professional networks and publication in scientific open access journals.
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Affiliation(s)
- Jan Kottner
- Institute of Clinical Nursing Science, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Alexandra Fastner
- Institute of Clinical Nursing Science, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Christopher E M Griffiths
- Department of Dermatology, King's College Hospital, King's College London, London, UK
- Centre for Dermatology Research, NIHR Manchester Biomedical Research Centre, The University of Manchester, Manchester, UK
| | - Ulrike Blume-Peytavi
- Department of Dermatology, Venerology and Allergology, Charité Universitätsmedizin Berlin, Berlin, Germany
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23
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Bruschi ML, de Souza Nunes GC. Magnetic Gels in Skin Cancer Treatment: A Review of Potential Applications in Diagnostics, Drug Delivery and Hyperthermia. Pharmaceutics 2023; 15:pharmaceutics15041244. [PMID: 37111728 PMCID: PMC10143045 DOI: 10.3390/pharmaceutics15041244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
Skin cancer (SC) is affecting an increasing number of people worldwide. Its lesions affect mainly the most exposed regions of the skin. SC is classified into to main categories: non-melanoma (basal cell carcinoma of the epidermis and squamous cell carcinoma) and melanoma (the abnormal proliferation of melanocytes, which is rarer, more hazardous, and more deadly). Prevention and early diagnosis are important actions, and surgery is often considered. After the removal of cancerous lesions, the local administration of medicine can guarantee anticancer therapeutic action, rapid healing and the recovery of tissue, ensuring the absence of recurrence. Magnetic gels (MGs) have attracted increased attention regarding their pharmaceutical and biomedical applications. They are magnetic nanoparticles (e.g., iron oxide nanoparticles) dispersed in a polymeric matrix, which constitute adaptive systems under a magnetic field. MGs can combine magnetic susceptibility, high elasticity, and softness, and are thus useful platforms for diagnostics, drug delivery, and also for hyperthermia. This manuscript reviews MGs as a technological strategy for the treatment of SC. An overview of SC and the treatment, types, and methods of preparing MGs are discussed. Moreover, the applications of MGs in SC and their future perspectives are considered. The combination of polymeric gels and magnetic nanoparticles continues to be investigated, and new products must hit the market. Clinical trials and new products are expected, due to the important advantages of MGs.
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Affiliation(s)
- Marcos Luciano Bruschi
- Laboratory of Research and Development of Drug Delivery Systems, Postgraduate Program in Pharmaceutical Sciences, Department of Pharmacy, State University of Maringa, Av. Colombo 5790, Maringa 87020-900, PR, Brazil
| | - Glécilla Colombelli de Souza Nunes
- Laboratory of Research and Development of Drug Delivery Systems, Postgraduate Program in Pharmaceutical Sciences, Department of Pharmacy, State University of Maringa, Av. Colombo 5790, Maringa 87020-900, PR, Brazil
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24
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Fastner A, Hauss A, Kottner J. Skin assessments and interventions for maintaining skin integrity in nursing practice: An umbrella review. Int J Nurs Stud 2023; 143:104495. [PMID: 37099847 DOI: 10.1016/j.ijnurstu.2023.104495] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/29/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Daily skin care routines are fundamental aspects of clinical nursing practice. Providing skin care, including skin cleansing and application of leave-on products have substantial impact on the prevention and treatment of a number of skin conditions. There are hundreds of individual studies about skin risks, classifications, skin conditions, prevention and treatment. OBJECTIVE To summarise the overall evidence regarding 1) risk factors associated with xerosis cutis, incontinence-associated dermatitis/diaper dermatitis, intertrigo, skin tears, 2) the performance of diagnostic tests and/or classifications addressing the severity and/or signs and symptoms of xerosis cutis, incontinence-associated dermatitis/diaper dermatitis, intertrigo, skin tears, 3) the effects of skin cleansing/care interventions for the maintenance and promotion of skin integrity in all age groups, 4) effects of skin cleansing/care interventions for the prevention of xerosis cutis, incontinence-associated dermatitis/diaper dermatitis, intertrigo, skin tears in all age groups. DESIGN Umbrella review. DATA SOURCES A systematic search in MEDLINE and Embase (via OvidSP), Cochrane and Epistemonikos was conducted. Reference lists and experts were consulted for potentially missed reviews. REVIEW METHODS Two reviewers screened titles/abstracts and full-texts independently. After rating the risk of bias only low to high overall confidence (AMSTAR 2) and low risk of bias (ROBIS) reviews were included. RESULTS Twelve systematic reviews were included. Due to substantial heterogeneity regarding study designs, methods, and outcomes all authors presented findings in a narrative synthesis. The validity and reliability of the International Skin Tear Advisory Panel classification is supported by moderate quality evidence, and the reliability and criterion validity for Skin Tear Audit Research were rated insufficient. Overall, review results indicate that structured skin care programs are preferable to unstructured skin care with classic soap and water for maintaining skin integrity in general, preventing skin tears, and to prevent and treat xerosis cutis and incontinence-associated dermatitis. All reviews focusing on leave-on products for the prevention and treatment of incontinence-associated dermatitis and diaper dermatitis indicate the effectiveness of barrier films or lipophilic leave-on products in adults, elderly people and paediatric care, but could not establish the superiority of any product. CONCLUSIONS The majority of systematic reviews in the field of skin care is at high risk of bias and should not be used for evidence-based practice. Overall, evidence indicates, that structured skin care programs containing low-irritating cleansers and application of leave-on products are beneficial to maintain skin integrity and prevent skin damage across a wide range of different skin conditions across the life span.
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25
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Völzer B, El Genedy-Kalyoncu M, Fastner A, Tomova-Simitchieva T, Neumann K, Sill J, Balzer K, Kottner J. Prevalence and associations of xerosis cutis, incontinence-associated dermatitis, skin tears, pressure ulcers, and intertrigo in aged nursing home residents: A representative prevalence study. Int J Nurs Stud 2023; 141:104472. [PMID: 36898269 DOI: 10.1016/j.ijnurstu.2023.104472] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 01/27/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND The number of elderly and care-dependent people is increasing, leading to increased risks of adverse skin conditions. Skin care, including prevention and treatment of vulnerable skin, is an essential part of daily nursing practice in long-term residential settings. For many years, the research focus has been on individual skin problems including xerosis cutis, incontinence-associated dermatitis, skin tears, pressure ulcers, and intertrigo, although people may be affected by several at the same time. OBJECTIVES Aim of the present study was to describe the prevalence and associations of skin conditions relevant to nursing practice in aged nursing home residents. DESIGN Analysis of baseline data of a cluster-RCT in long-term residential settings. SETTING The study was conducted in a representative sample of n = 17 nursing homes in the federal state of Berlin, Germany. PARTICIPANTS Care dependent nursing home residents being 65+ years. METHODS A random sample of all eligible nursing homes was drawn. Demographic and health characteristics were collected and head-to-toe skin examinations conducted by dermatologists. Prevalence estimates and intracluster correlation coefficients were calculated, and group comparisons conducted. RESULTS Three hundred fourteen residents with a mean age of 85.4 (SD 7.1) years were included. The majority was affected by xerosis cutis (95.9%, 95% CI 93.6 to 97.8), followed by intertrigo 35.0% (95% CI 30.0 to 40.1), incontinence-associated dermatitis 21.0% (95% CI 15.6 to 26.3), skin tears 10.5% (95% CI 7.3 to 13.8), and pressure ulcers 8.0% (95% CI 5.1 to 10.8). In total, more than half of the nursing home residents were affected by two or more skin conditions at the same time. Several associations between skin conditions and mobility, care dependency, or cognitive impairment were observed. There were no associations between xerosis cutis, incontinence-associated dermatitis, skin tears, pressure ulcers or intertrigo. CONCLUSIONS The adverse skin and tissue conditions xerosis cutis, incontinence-associated dermatitis, skin tears, pressure ulcers and intertrigo are very common in long-term residential settings, placing a high burden on this population. Although care receivers share similar risk factors and may be affected by several skin conditions at the same time, there are no associations indicating separate aetiological pathways. REGISTRATION This study is registered at the German Clinical Trials Register (registration number: DRKS00015680; date of registration: January 29th, 2019) and ClinicalTrials.gov (NCT03824886; date of registration: January 31st, 2019).
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Affiliation(s)
- Bettina Völzer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Monira El Genedy-Kalyoncu
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Alexandra Fastner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany
| | - Tsenka Tomova-Simitchieva
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Department of Dermatology and Allergy, Charitéplatz 1, 10117 Berlin, Germany
| | - Konrad Neumann
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Biometry and Clinical Epidemiology, Charitéplatz 1, 10117 Berlin, Germany
| | - Janna Sill
- University of Lübeck, Nursing Research Unit, Institute for Social Medicine and Epidemiology, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Katrin Balzer
- University of Lübeck, Nursing Research Unit, Institute for Social Medicine and Epidemiology, Ratzeburger Allee 160, 23562 Lübeck, Germany
| | - Jan Kottner
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt, Universität zu Berlin, Institute of Clinical Nursing Science, Charitéplatz 1, 10117 Berlin, Germany; Ghent University, Faculty of Medicine and Health Sciences, Belgium.
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User Experience in Cosmetics: Perception Analysis Regarding the Use of an Anti-Aging Moisturizer. COSMETICS 2023. [DOI: 10.3390/cosmetics10010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
One of the most important characteristics of aging skin is dehydration, which is why the use of moisturizing products is very important, especially with increasing age. Thus, the user’s experience when using a product is interesting for the companies to develop specific cosmetics not only considering the physiological needs of each skin, but also according to the preference of a group if there is any. For this, a moisturizer was developed, containing an antioxidant active, ascorbyl tetraisopalmitate, whose sensory characteristics were evaluated by 33 Brazilian women between 30 and 60 years old. The results showed that the formulation was well accepted by all subjects, regardless of their age group, initial hydration, or the presence of visible signs of skin aging. It is suggested that the presence of the active ingredient in different concentrations caused a different perception of the formula for specific attributes such as the aqueous residue, film formation, and the feelings of oiliness and stickiness to the skin after application. These results suggest that the perception of the sensory characteristics of the product was more related to the nature and proportion of the compounds than to the age of the subjects.
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27
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Burlando M, Castelli R, Salvi I, Cozzani E, Parodi A. A novel moisture for xerosis in psoriatic patients: a single center study. Ital J Dermatol Venerol 2023; 158:39-41. [PMID: 36800804 DOI: 10.23736/s2784-8671.23.07364-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Xerosis is an extremely common condition, especially in the elderly population. It is the most common cause of pruritus in the older adult. Since xerosis is generally caused by a lack of epidermal lipids, the use of leave-on skin care products is the mainstay treatment. The aim of this open prospective analytical observational study was to investigate the clinical and self-reported hydrating efficacy of a moisturizer formulation containing a synergy between amino-inositol and urea (INOSIT-U 20) in patients with psoriasis and xerosis. METHODS Twenty-two patients with psoriasis successfully treated with biologic therapy, and who presented xerosis, were recruited. Each patient was instructed to apply the topical with a frequency of two applications per die on the identified skin area. Corneometry values and a VAS itch questionnaire were measured at baseline (T0) and after 28 days (T4). To evaluate the cosmetic efficacy, the volunteers also completed a self-assessment questionnaire. RESULTS Comparing Corneometry values at T0 and T4, a statistically significant increase value was observed in the area subjected to topical treatment (P<0.0001). A significant decrease in itch (P=0.001) was also observed. Moreover, the patients' ratings of the cosmetic properties of the moisturizer showed significant confirmation rates. CONCLUSIONS This study provides preliminary evidence that INOSIT-U20 provides a good hydrating effect on xerosis, further reducing self-reported itch.
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Affiliation(s)
- Martina Burlando
- Section of Dermatology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, University of Genoa, Genoa, Italy -
| | - Riccardo Castelli
- Section of Dermatology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, University of Genoa, Genoa, Italy
| | - Ilaria Salvi
- Section of Dermatology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, University of Genoa, Genoa, Italy
| | - Emanuele Cozzani
- Section of Dermatology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, University of Genoa, Genoa, Italy
| | - Aurora Parodi
- Section of Dermatology, Department of Health Sciences (DISSAL), IRCCS San Martino University Hospital, University of Genoa, Genoa, Italy
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Cilluffo S, Bassola B, Beeckman D, Lusignani M. Risk of skin tears associated with nursing interventions: A systematic review. J Tissue Viability 2023; 32:120-129. [PMID: 36577638 DOI: 10.1016/j.jtv.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/08/2022] [Accepted: 11/27/2022] [Indexed: 12/07/2022]
Abstract
BACKGROUND Skin tears are a significant problem for patients and healthcare professionals. They can cause pain, impact quality of life, and become chronic and infected. The risk of skin tears is associated with dependence in daily life activities and with nursing interventions. OBJECTIVES To examine which nursing interventions increase the risk of skin tears. DESIGN Systematic review. DATA SOURCES The MEDLINE, CINAHL, Scopus, and Cochrane Library databases were searched in March 2022. PUBLICATION YEARS Publications included were from 2012 to 2022. RESULTS Seventeen articles were included in the final analysis reporting nursing interventions associated with the risk of skin tears. Hygiene with cold water and soap, not applying leave-on products to moisten/protect dehydrated skin, and wearing short sleeves were found to be associated with skin tears. Transferring patients into and out of bed in a rough manner and wearing jewelry or long nails can increase the risk of skin tears. Removal of adhesive dressings or bandages can also cause skin tears. CONCLUSION Nursing staff need to know which interventions put their patients at risk of skin tears and which interventions are recommended to prevent skin tears. Nursing care can affect the health of the patient's skin.
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Affiliation(s)
- Silvia Cilluffo
- School of Nursing, University of Milan, ASST GOM Niguarda, Milan, Italy; Department Biomedicine and Prevention, University of Rome, Tor Vergata, Rome, Italy.
| | - Barbara Bassola
- School of Nursing, University of Milan, ASST GOM Niguarda, Milan, Italy
| | - Dimitri Beeckman
- Faculty of Medicine and Health, School of Health Sciences, Nursing Science Unit, Swedish Centre for Skin and Wound Research, Örebro University, Sweden; Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Belgium
| | - Maura Lusignani
- School of Nursing, University of Milan, ASST GOM Niguarda, Milan, Italy; Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
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29
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de Faria MF, Ferreira MBG, dos Santos Felix MM, Bessa RMV, Barbosa MH. Prevention of medical adhesive-related skin injury during patient care: A scoping review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100078. [PMID: 38745606 PMCID: PMC11080338 DOI: 10.1016/j.ijnsa.2022.100078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 11/22/2022] Open
Abstract
Background : Medical adhesive-related skin injury can occur during health care. Professionals must adopt preventive measures to maintain the integrity of the skin and patient comfort and safety. Objective : To map the existing scientific evidence on preventing medical adhesive-related skin injury in adults. Design : Scoping Review. Methods : Searches were conducted in PubMed/Medline, Cochrane Library, Embase®, Latin American and Caribbean Literature in Health Sciences, Cumulative Index for Nursing and Allied Health Literature, and Google Scholar, without period delimitation. Duplicate studies and those that didn´t answer the research question were excluded. Results : Of the 209 studies identified in the search process, 30 made up the final sample. The prevention of injury by adhesives mainly involves identifying risk factors, proper adhesive selection, and correct application and removal. Health education and medical records about injuries related to medical adhesives are essential. Conclusions : The prevention of medical adhesive-related skin injury should be done by adopting multifactorial measures, which range from identifying risk factors and correct handling of adhesives to the process of educating professionals, patients and communities about these injuries. Registration : The research was registered on the Open Science Framework DOI 10.17605/OSF.IO/NSWP8.
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Affiliation(s)
- Maíla Fidalgo de Faria
- Stricto Sensu Graduate Program in Health Care, Federal University of Triângulo Mineiro, Uberaba/MG, Brazil
| | | | | | | | - Maria Helena Barbosa
- Stricto Sensu Graduate Program in Health Care, Federal University of Triângulo Mineiro, Uberaba/MG, Brazil
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30
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Rashid M, Harish SP, Mathew J, Kalidas A, Raja K. Comprehensive rehabilitation outcome measurement scale (CROMS): development and preliminary validation of an interdisciplinary measure for rehabilitation outcomes. Health Qual Life Outcomes 2022; 20:160. [PMID: 36456958 PMCID: PMC9714173 DOI: 10.1186/s12955-022-02048-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 09/15/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Comprehensive and interdisciplinary measurement of rehabilitation outcome is an essential part of the assessment and prognosis of a patient. Thus, this requires substantial contributions from the patient, their family and the rehabilitation professional working with them. Moreover, the measurement tool should be comprehensive and must consider the cultural compatibility, cost efficiency and contextual factors of the region. METHODS The Comprehensive Rehabilitation Outcome Measurement Scale (CROMS) was developed through consensus and followed the Delphi process incorporating inputs from various rehabilitation professionals. The domains and items were finalized using Principal Component Analysis (PCA). The tool was validated in two native languages and back-translated considering the semantic equivalence of the scale. Intra-class correlation coefficient was performed to determine the agreement between the therapist and patient-reported scales. RESULTS The final CROMS carries 32 comprehensive items that can be completed by the person with disability and the professional team. CROMS compares well to similar items on FIM (l ICC of 0.93) and has good internal consistency with a Cronbach's Alpha of 0.92 for both patient and therapist reported measures. CONCLUSIONS The 32 item CROMS is a tool that can potentially be used to evaluate the functional independence of various patient populations, predominantly patients with neurological disabilities.
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Affiliation(s)
| | | | | | | | - Kavitha Raja
- JSS College of Physiotherapy, Mysuru, 570004, India
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31
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Miles SJ, Fulbrook P, Williams DM. Skin tear prevalence in an Australian acute care hospital: A 10-year analysis. Int Wound J 2022; 19:1418-1427. [PMID: 34951125 PMCID: PMC9493203 DOI: 10.1111/iwj.13735] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/17/2021] [Accepted: 12/01/2021] [Indexed: 12/03/2022] Open
Abstract
Hospital-acquired skin tear prevalence is under-reported; thus, the aim of this study was to analyse skin tear point prevalence and characteristics in a tertiary acute care hospital in Queensland, Australia, over a 10-year period. All consenting adult inpatients received a full skin inspection and skin tear category, site, cause, treatment, and whether it was documented as hospital- or community-acquired were recorded. Eleven prevalence audits were analysed with a total sample of 3626 patients. An overall pooled prevalence of 8.9% (95% confidence interval [CI] 7.5-10.4) with an associated hospital-acquired pooled prevalence of 5.5% (95% CI 4.5-6.7) was found. In total, 616 skin tears were reported, of which 374 (60.7%) were hospital-acquired. Over a third of patients (38.7%) had multiple skin tears and most patients (84.8%) with at least one skin tear were aged ≥70 years. The largest proportion of skin tears (40.1%) was those with no skin flap. Of those documented, most were caused by falls or collisions, suggesting combined skin tear and falls prevention strategies may be effective. Over a decade, there was a downward trend in hospital-acquired skin tear, which is encouraging. Skin tear prevalence is recommended as a measure of care quality with an emphasis on good quality documentation.
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Affiliation(s)
- Sandra J. Miles
- School of Nursing, Midwifery and Paramedicine (Brisbane), Faculty of Health SciencesAustralian Catholic UniversityVirginiaQueenslandAustralia
- Nursing Research and Practice Development CentreThe Prince Charles HospitalChermsideQueenslandAustralia
| | - Paul Fulbrook
- School of Nursing, Midwifery and Paramedicine (Brisbane), Faculty of Health SciencesAustralian Catholic UniversityVirginiaQueenslandAustralia
- Nursing Research and Practice Development CentreThe Prince Charles HospitalChermsideQueenslandAustralia
- Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Damian M. Williams
- Wound Management, Clinical Effectiveness ProgramThe Prince Charles HospitalChermsideQueenslandAustralia
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32
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El Genedy-Kalyoncu M, Fastner A, Völzer B, Raeder K, Neumann K, Lahmann NA, Kottner J. Comparison of two skin protection regimes for the Prevention of Incontinence-associated Dermatitis in geriatric care (PID): a study protocol for an exploratory randomised controlled pragmatic trial. BMJ Open 2022; 12:e065909. [PMID: 36175092 PMCID: PMC9528637 DOI: 10.1136/bmjopen-2022-065909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION The majority of aged long-term care receivers and patients in geriatric acute care are affected by some form of incontinence. These individuals are at risk of developing incontinence-associated dermatitis (IAD), a common type of irritant contact dermatitis caused by repeated and prolonged direct contact of the skin with urine and stool. The prevalence of IAD in these settings is high. Preventive measures include mild skin cleansing and the application of skin protecting leave-on products. Available evidence is weak regarding the comparative performance of different skin protection strategies and products due to a lack of confirmatory trials using relevant comparators and endpoints. Therefore, the overall aim of this exploratory trial is to compare the effects of three skin protection strategies to estimate effect sizes of the recently published core outcomes in IAD research. METHODS AND ANALYSIS A pragmatic three-arm, assessor-blinded, randomised controlled, exploratory trial with parallel group design will be performed, comparing film-forming and lipophilic skin protecting leave-on products for IAD prevention with standard incontinence care alone. The trial will be conducted in geriatric nursing homes and geriatric acute care settings in the federal state of Berlin, Germany. A total of n=210 participants being incontinent of urine and stool will be included. Outcomes include IAD incidence, erythema, erosion, maceration, IAD-related pain, patient satisfaction, safety, feasibility and compliance. IAD incidence of the control and intervention groups will be compared to estimate effect sizes, and the procedural feasibility of the intervention will be tested to plan a possible subsequent confirmatory randomised controlled trial. ETHICS AND DISSEMINATION The study received the approval of the ethics committee of Charité-Universitätsmedizin Berlin (EA4/043/22). Results will be disseminated through peer-reviewed open-access journals and international conferences. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT05403762) and German Clinical Trials Register (Deutsches Register Klinischer Studien, or DRKS) (DRKS00028954).
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Affiliation(s)
| | - Alexandra Fastner
- Institute of Clinical Nursing Science, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Bettina Völzer
- Institute of Clinical Nursing Science, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kathrin Raeder
- Department of Geriatrics and Medical Gerontology, Research Group Geriatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Konrad Neumann
- Department of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Nils Axel Lahmann
- Department of Geriatrics and Medical Gerontology, Research Group Geriatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Kottner
- Institute of Clinical Nursing Science, Charité-Universitätsmedizin Berlin, Berlin, Germany
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A Green Tea Containing Skincare System Improves Skin Health and Beauty in Adults: An Exploratory Controlled Clinical Study. COSMETICS 2022. [DOI: 10.3390/cosmetics9050096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Skin dryness, fine lines and wrinkles, red spots, red vasculature, and porphyrin count are common indicators of skin health and beauty. The skincare system in this study contains scientifically validated ingredients such as fermented green tea (Camellia sinensis) water, niacinamide, antioxidants, and a variety of natural plant extracts. The purpose of this study was to evaluate the effectiveness of this skincare system in improving facial-skin health and beauty. Twenty-six healthy adults, both female and male, aged 18–54 and of all skin types and tones, were included in the study and participated as either the active or the control group (competitor product) using designated topical products for 30 days. Skin moisture, fine lines and wrinkles, porphyrin count, red spots, and red vasculature count were measured through high-quality photography, Visia® complexion analysis, FitSkin® skin analysis, and survey questions on day 0, day 8, and day 30. Significant improvements were observed in facial moisture, red-spot count, red vasculature count, and porphyrin count on day 30 in comparison with the control group. Non-significant improvements were observed in pores, skin texture, and wrinkles. With extensive well-documented functional ingredients, the studied skincare system used daily may significantly improve key areas of skin health and beauty.
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Abstract
OBJECTIVE To systematically review recommendations for promoting and maintaining skin integrity in end-of-life care and their level of evidence. DATA SOURCES MEDLINE (PubMed interface), CINAHL (Cumulative Index to Nursing and Allied Health Literature), EMBASE, and The Cochrane Library were systematically searched using a combination of key terms including end-of-life care, skin care, skin hygiene, and skin cleansing. STUDY SELECTION Articles were included if they (1) described skin care recommendations, including but not limited to the use of skin care products and interventions such as cleansing procedures; and (2) included adult patients who were expected to die within 12 months. There were no restrictions on study design, study setting, or language. Articles with a publication date before 2000 were excluded. DATA EXTRACTION Two data extraction forms were developed. The first included information about the author, publication year, type of evidence, study topic, sample, sample size, setting, limitations of the study, level of evidence, and quality of the study. The second included recommendations for promoting and maintaining skin integrity in patients at the end of life. DATA SYNTHESIS Because of methodological heterogeneity, results were synthesized narratively, and no meta-analysis was performed. CONCLUSIONS The information contained in the recommendations will assist nurses in promoting and maintaining skin integrity in patients at the end of life. More research is needed on end-of-life skin care, with an emphasis on patient-centered, holistic strategies that improve patient well-being and quality of life. In most current research, recommendations are limited to literature reviews and level V evidence. Skin care must balance the promotion and maintenance of skin integrity, wound prevention, and management while promoting patient dignity and quality of life.
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Wang W, Li Q, Zhao Z, Liu Y, Wang Y, Xiong H, Mei Z. Paeonol Ameliorates Chronic Itch and Spinal Astrocytic Activation via CXCR3 in an Experimental Dry Skin Model in Mice. Front Pharmacol 2022; 12:805222. [PMID: 35095512 PMCID: PMC8794748 DOI: 10.3389/fphar.2021.805222] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/23/2021] [Indexed: 01/13/2023] Open
Abstract
Paeonol is a bioactive phenol presents mainly in Paeonia suffruticosa Andr. (Paeoniaceae), Paeonia lactiflora Pall., and Dioscorea japonica Thunb. (Dioscoreaceae), harboring various pharmacological activities including anti-inflammatory, antioxidant, immune regulatory activity and reverse chemoresistance. Recent reports revealed paeonol exhibited good effects on chronic dermatitis, such as atopic dermatitis (AD) and psoriasis. However, whether paeonol is effective for dry skin disease and its mechanism of action still remain unclear. In this study, we analysed the effects of paeonol on a mouse model of dry skin treated with acetone-ether-water (AEW), which showed impressive activities in reducing scratching behavior and skin inflammation. To elucidate the underlying molecular targets for the anti-pruritic ability of paeonol, we screened the expression of possible chemokine pathways in the spinal cord. The expression of CXCR3 was significantly alleviated by paeonol, which increased greatly in the spinal neurons of AEW mice. In addition, treatment of paeonol significantly inhibited AEW-induced expression of astrocyte activity-dependent genes including Tlr4, Lcn2 and Hspb1 et al. The inhibitory effects of paeonol on scratching behavior and astrocytic activation in the spinal cord induced by AEW were abolished when CXCR3 was antagonized or genetically ablated. Taken together, our results indicated that paeonol can ameliorate AEW-induced inflammatory response and itching behavior, and reduce the expression of spinal astrocyte activity-dependent genes induced by AEW, which are driven by CXCR3.
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Affiliation(s)
- Wen Wang
- School of Pharmaceutical Sciences, South-Central University for Nationalities, Wuhan, China.,Institute of Ethnomedicine, South-Central University for Nationalities, Wuhan, China
| | - Qiaoyun Li
- School of Pharmaceutical Sciences, South-Central University for Nationalities, Wuhan, China.,Institute of Ethnomedicine, South-Central University for Nationalities, Wuhan, China
| | - Zhongqiu Zhao
- Washington University School of Medicine, St. Louis, MO, United States.,Barnes-Jewish Hospital, St. Louis, MO, United States
| | - Yutong Liu
- College of Life Sciences, South-Central University for Nationalities, Wuhan, China
| | - Yi Wang
- College of Life Sciences, South-Central University for Nationalities, Wuhan, China
| | - Hui Xiong
- School of Pharmaceutical Sciences, South-Central University for Nationalities, Wuhan, China.,Institute of Ethnomedicine, South-Central University for Nationalities, Wuhan, China
| | - Zhinan Mei
- School of Pharmaceutical Sciences, South-Central University for Nationalities, Wuhan, China.,Institute of Ethnomedicine, South-Central University for Nationalities, Wuhan, China
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Dalgleish L, Campbell J. Xerosis in Older Adults. Adv Skin Wound Care 2022; 35:62-63. [PMID: 34935723 DOI: 10.1097/01.asw.0000803780.72502.f4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Lizanne Dalgleish
- Lizanne Dalgleish, PhD, RN, GCertClinEpid, is Clinical Nurse Consultant and Skin Integrity Improvement Facilitator, Northern Sydney Local Health District, NSW Health, Sydney, Australia. Jill Campbell, PhD, RN, BHealth SC(Nursing), Grad Dip(Wound Care), is Senior Research Fellow, National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Queensland, Australia
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Amin R, Lechner A, Vogt A, Blume-Peytavi U, Kottner J. Molecular characterization of xerosis cutis: A systematic review. PLoS One 2021; 16:e0261253. [PMID: 34914754 PMCID: PMC8675746 DOI: 10.1371/journal.pone.0261253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/26/2021] [Indexed: 12/28/2022] Open
Abstract
Background Xerosis cutis or dry skin is a highly prevalent dermatological disorder especially in the elderly and in patients with underlying health conditions. In the past decades, numerous molecular markers have been investigated for their association with the occurrence or severity of skin dryness. The aim of this review was to summarize the molecular markers used in xerosis cutis research and to describe possible associations with different dry skin etiologies. Methods We conducted a systematic review of molecular markers of xerosis cutis caused by internal or systemic changes. References published between 1990 and September 2020 were searched using ‘MEDLINE’, ‘EMBASE’ and ‘Biological abstracts’ databases. Study results were summarized and analyzed descriptively. The review protocol was registered in PROSPERO database (CRD42020214173). Results A total of 21 study reports describing 72 molecules were identified including lipids, natural moisturizing factors (NMFs), proteins including cytokines and metabolites or metabolic products. Most frequently reported markers were ceramides, total free fatty acids, triglycerides and selected components of NMFs. Thirty-one markers were reported only once. Although, associations of these molecular markers with skin dryness were described, reports of unclear and/or no association were also frequent for nearly every marker. Conclusion An unexpectedly high number of various molecules to quantify xerosis cutis was found. There is substantial heterogeneity regarding molecular marker selection, tissue sampling and laboratory analyses. Empirical evidence is also heterogeneous regarding possible associations with dry skin. Total free fatty acids, total ceramide, ceramide (NP), ceramide (NS), triglyceride, total free amino acids and serine seem to be relevant, but the association with dry skin is inconsistent. Although the quantification of molecular markers plays an important role in characterizing biological processes, pathogenic processes or pharmacologic responses, it is currently unclear which molecules work best in xerosis cutis.
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Affiliation(s)
- Ruhul Amin
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Berlin, Germany
- BCSIR Laboratories Dhaka, Bangladesh Council of Scientific and Industrial Research, Dhaka, Bangladesh
| | - Anna Lechner
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - Annika Vogt
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - Ulrike Blume-Peytavi
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Dermatology, Venereology and Allergology, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - Jan Kottner
- Charité-Universitätsmedizin Berlin, Institute of Clinical Nursing Science, Berlin, Germany
- * E-mail:
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Banharak S, Panpanit L, Subindee S, Narongsanoi P, Sanun-Aur P, Kulwong W, Songtin P, Khemphimai W. Prevention and Care for Incontinence-Associated Dermatitis Among Older Adults: A Systematic Review. J Multidiscip Healthc 2021; 14:2983-3004. [PMID: 34729012 PMCID: PMC8556723 DOI: 10.2147/jmdh.s329672] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/28/2021] [Indexed: 12/25/2022] Open
Abstract
Background The prevalent rate of incontinence-associated dermatitis (IAD) trends upward in older populations. Skin breakdown from IAD impacts the quality of life of older adults and reflects the quality of care in hospitals and long-term care facilities. Specific and appropriate interventions for prevention and care are needed. This systematic review aims to review optimal strategies for prevention and care for older adults with IAD. Methods PubMed, CINAHL, SCOPUS, Medline, ProQuest, ThaiLIS, ThaiJo, and E-Thesis were searched for articles published between January 2010 and December 2020. Only articles focusing on older adults were included for the review. Results Eleven articles met the inclusion/exclusion criteria. Interventions for the prevention and care of IAD among older adults were categorized as assessment, incontinence management/causative factors management, cleansing, application of medical products for both skin moisturizing and skin barrier, body positioning, nutrition promotion, health education and training, and outcome evaluation. Specific prevention and care strategies for older adults with IAD included using specific assessment tools, applying skin cleansing pH from 4.0 to 6.8, body positioning, and promoting food with high protein. Other strategies were similar to those reported for adult patients. Conclusion The systematic review extracted current and specific prevention and care strategies for IAD in older adults. The prevention and care strategies from this systematic review should be applied in clinical practice. However, more rigorous research methodology is recommended in future studies, especially in examining intervention outcomes. Nurses and other health professionals should be educated and trained to understand the causes of IAD in older adults and the specific prevention and care strategies for this population. Because older adults are prone to skin damage, and this type of skin breakdown differs from pressure ulcers, the tools for assessment and evaluation, and the strategies for prevention and care require special attention. Prospero Registration Number CRD42021251711. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/nGSwevz-SIQ
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Affiliation(s)
- Samoraphop Banharak
- Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
| | - Ladawan Panpanit
- Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
| | - Suttinan Subindee
- Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand
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Li Z, Marshall AP, Lin F, Ding Y, Chaboyer W. Pressure injury prevention practices among medical surgical nurses in a tertiary hospital: An observational and chart audit study. Int Wound J 2021; 19:1165-1179. [PMID: 34729917 PMCID: PMC9284631 DOI: 10.1111/iwj.13712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/13/2021] [Accepted: 10/20/2021] [Indexed: 11/26/2022] Open
Abstract
Pressure injuries are frequently occurring adverse events in hospitals, negatively impacting patient safety and quality of care. Most pressure injuries are avoidable if effective prevention strategies are used. However, the extent to which various settings influence their use of prevention strategies is unknown. The aim of this study was to describe and compare pressure injury prevention strategies used by medical and surgical nurses in the Chinese context. In this observational study, we used semi-structured observations with chart audits to collect data in two medical and two surgical wards in a tertiary hospital from June to December 2020. Observations were patient-focused; any prevention practices the patient received were recorded, and a chart audit was used to identify documented prevention strategies. The frequency of each prevention strategy was reported, and differences between medical and surgical wards were analysed using independent t-test or χ2 test. A total of 577 patients (n = 294, 50.9% medical; n = 283, 49.1% surgical) were observed and their charts audited. Risk assessment was completed on admission for all patients. Repositioning was the most frequently used strategy, with about 84% (n = 486) patients being repositioned regularly. However, skin care, nutritional risk screening and the use of support surfaces were suboptimal. Patient education was not commonly observed but was documented in 75% (n = 433) of audited charts. More medical patients' skin was kept clean and hydrated, but more surgical patients received barrier creams, had a support surface and received more nutrition support and if a prone position was used, they were more likely to be turned after 2 hr and to be repositioned after sitting in a chair for an hour. Prevention strategies were more likely to be documented in surgical patients' charts. Despite pressure injury prevention guideline recommendations provided various prevention strategies for nurses to apply, the observed use of some strategies such as nutrition, skin care and support surfaces was not ideal. Nurses relied heavily on repositioning for pressure injury prevention. Most pressure injury prevention practices need improvement although surgical patients generally received better preventative care. These findings can facilitate clinicians and nurse managers when tailoring future pressure injury prevention work.
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Affiliation(s)
- Zhaoyu Li
- School of Nursing and Midwifery, Griffith University, Menzies Health Institute Queensland, Gold Coast, Queensland, Australia
| | - Andrea P Marshall
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.,Nursing and Midwifery Education and Research Unit, Gold Coast Health, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Frances Lin
- School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.,School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Yanming Ding
- Nursing Department, Peking University First Hospital, Beijing, China
| | - Wendy Chaboyer
- NHMRC Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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Konya I, Iwata H, Hayashi M, Akita T, Homma Y, Yoshida H, Yano R. Effectiveness of weak wiping pressure during bed baths in hospitalized older adults: A single-blind randomized crossover trial. Geriatr Nurs 2021; 42:1379-1387. [PMID: 34583237 DOI: 10.1016/j.gerinurse.2021.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 01/07/2023]
Abstract
This study evaluated the effectiveness of weak wiping pressure on skin barrier function and patient satisfaction in comparison to ordinary pressure in hospitalized older adults. Forty-seven participants in a general hospital were blindly and randomly assigned a sequence of two bed baths: wiping three times with weak pressure (12-14 mmHg) and ordinary pressure (23-25 mmHg). Transepidermal water loss and stratum corneum hydration were measured before and after the intervention, and patient satisfaction was assessed using a Likert scale. Ordinary pressure significantly decreased skin barrier function compared to weak pressure; however, neither of the pressures caused discomfort. Weak pressure was more effective than ordinary pressure in preventing skin disorders and providing satisfaction. Subgroup cluster analysis showed that ordinary pressure was likely to impair the skin barrier function in older adults with diabetes/dyslipidemia and renal dysfunction. The application of weak pressure during bed baths, especially for these patients, is recommended.
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Affiliation(s)
- Issei Konya
- Graduate School of Health Sciences, Hokkaido University, Hokkaido, Japan
| | - Hiroaki Iwata
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Hokkaido, Japan
| | - Miyuki Hayashi
- Division of Nursing, Hokkaido University Hospital, Hokkaido, Japan
| | - Tamami Akita
- Division of Nursing, Hokkaido University Hospital, Hokkaido, Japan
| | - Yoshie Homma
- Social Welfare Corporation Hokkaido Shakaijigyokyokai Yoichi Hospital, Hokkaido, Japan
| | - Hideaki Yoshida
- Social Welfare Corporation Hokkaido Shakaijigyokyokai Yoichi Hospital, Hokkaido, Japan
| | - Rika Yano
- Faculty of Health Sciences, Hokkaido University, Hokkaido, Japan.
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41
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Chen G, Huang L, Chen Y, Zheng S, Zhu L, Ding M. Establishment of incontinence-associated dermatitis rat models and assessment of the therapeutic effects of zinc oxide, painless skin protective film and silicone dressing. Exp Ther Med 2021; 22:1058. [PMID: 34434272 PMCID: PMC8353640 DOI: 10.3892/etm.2021.10492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 07/01/2021] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to construct incontinence-associated dermatitis (IAD) rat models and observe the therapeutic effects of zinc oxide, painless skin protective film and silicone dressing on IAD. A total of 54 rats were randomly divided into nine groups: i) Control group; ii) trypsin model group; iii) model + zinc oxide group; iv) model + painless skin protective film group; v) model + silicon dressing group; vi) synthetic urine combined with trypsin model group (joint model group); vii) joint model + zinc oxide group; viii) joint model + painless skin protective film group; and ix) joint model + silicone dressing group. A total of 4 days after applying the zinc oxide, protective film or silicon dressing intervention, IAD scores and pH values in skin tissues were examined. Skin tissues and blood samples were collected. Hematoxylin and eosin staining, immunohistochemical staining of major histocompatibility complex class II (MHC-II) and western blot analysis of MHC-II, NF-κB/p65, phosphorylated (p)-NF-κB/p65, STAT1 and p-STAT1 were carried out in skin tissue. Serum IFN-γ, IL-1β, IL-2 and TNF-α levels were determined using ELISA. The results demonstrated that IAD scores and pH values were both higher in the model groups than the control, which were significantly ameliorated by silicone dressing. The skin tissue structure of IAD rats both in trypsin model group and joint model group was severely damaged, the wounds were not covered by epidermis, and numerous inflammatory cell infiltrations were observed. After treatment, dermatitis was improved. Skin tissue from the trypsin and joint IAD models had higher MHC-II, NF-κB p65, p-NF-κB p65, STAT1 and p-STAT1 expression than controls, which was decreased by protective film and silicon dressing. Zinc oxide reduced NF-κB p65, p-NF-κB p65, STAT1 and p-STAT1 expression. However, no significant differences were observed in NF-κB/p-NF-κB ratio and STAT1/p-STAT1 ratio among groups. Furthermore, serum IFN-γ, IL-1β, IL-2 and TNF-α levels were significantly elevated in trypsin and joint IAD rats. The upregulation of these cytokines was significantly inhibited after all three treatments. Among the three treatment methods, silicone dressing had the best therapeutic effect. Thus, these findings revealed that zinc oxide, painless skin protective film and silicone dressing could ameliorate the severity of IAD rat models, and that silicone dressing possessed the best therapeutic effect.
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Affiliation(s)
- Guiyuan Chen
- Nursing Faculty, School of Medicine, Jinhua Polytechnic, Jinhua, Zhejiang 321007, P.R. China
| | - Liquan Huang
- Nursing Faculty, School of Medicine, Jinhua Polytechnic, Jinhua, Zhejiang 321007, P.R. China
| | - Yingxun Chen
- Department of General Medicine, Jinhua Municipal Central Hospital, Jinhua, Zhejiang 321000, P.R. China
| | - Shufeng Zheng
- Department of Gastroenterology, Jinhua People's Hospital, Jinhua, Zhejiang 321000, P.R. China
| | - Louying Zhu
- Jinhua Center of Laboratory Animals, Jinhua Municipal Food and Drug Inspection Institute, Jinhua, Zhejiang 321000, P.R. China
| | - Mingxing Ding
- Medical Molecular Biology Laboratory, School of Medicine, Jinhua Polytechnic, Jinhua, Zhejiang 321007, P.R. China
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Dissemond J, Assenheimer B, Gerber V, Hintner M, Puntigam MJ, Kolbig N, Koller S, Kurz P, Läuchli S, Probst S, Protz K, Steiniger A, Strohal R, Traber J, Kottner J. Flüssigkeits‐assoziierte Hautschäden (FAH): Eine
Best Practice
Empfehlung von Wund‐D.A.CH. J Dtsch Dermatol Ges 2021; 19:815-827. [PMID: 34139095 DOI: 10.1111/ddg.14388_g] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/01/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Joachim Dissemond
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum, Essen, Deutschland
| | - Bernd Assenheimer
- Schule für Pflegeberufe, Universitätsklinikum, Tübingen, Deutschland
| | - Veronika Gerber
- Schulung und Beratung im Wundmanagement, Spelle, Deutschland
| | | | | | - Norbert Kolbig
- Stabstelle Wundmanagement, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | | | - Peter Kurz
- WPM Wund Pflege Management, Bad Pirawarth, Österreich
| | | | | | - Kerstin Protz
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen, CWC - Comprehensive Wound Center, Universitätsklinikum Hamburg, Hamburg, Deutschland
| | | | - Robert Strohal
- Abteilung für Dermatologie und Venerologie, Landeskrankenhaus Feldkirch, Feldkirch, Österreich
| | - Jürg Traber
- Chirurgie/Gefässchirurgie FEBVS, Phlebologie SGP, Venenklinik Bellevue, Kreuzlingen, Schweiz
| | - Jan Kottner
- CharitéCentrum 1 für Human- und Gesundheitswissenschaften, Charité -Universitätsmedizin Berlin, Berlin, Deutschland
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Burch J, Boyles A, Maltby E, Marsden J, Martin N, McDermott B, Voegeli D. Keep it simple: peristomal skin health, quality of life and wellbeing. ACTA ACUST UNITED AC 2021; 30:5-24. [PMID: 33949894 DOI: 10.12968/bjon.2021.30.sup6.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jennie Burch
- (chair), Head of Gastrointestinal Nurse Education, St Mark's Hospital, London North West University Healthcare NHS Foundation Trust
| | - Anna Boyles
- Stoma Care Nurse, King's College Hospital NHS Foundation Trust
| | - Emma Maltby
- Stoma Care Nurse, Hampshire Hospitals NHS Foundation Trust
| | - Jenny Marsden
- Stoma Care Nurse, York Teaching Hospital NHS Foundation Trust
| | - Nuria Martin
- Tissue Viability Nurse, St Mark's Hospital, London North West University Healthcare NHS Foundation Trust
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El Genedy-Kalyoncu M, Richter C, Surber C, Blume-Peytavi U, Kottner J. The effect of a basic skin care product on the structural strength of the dermo-epidermal junction: An exploratory, randomised, controlled split-body trial. Int Wound J 2021; 19:426-435. [PMID: 34121334 PMCID: PMC8762572 DOI: 10.1111/iwj.13643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 12/17/2022] Open
Abstract
Skin ageing is associated with various structural alterations including a decreased strength of the dermo‐epidermal adhesion increasing the risk for shear type injuries (skin tears). Topical applications of basic skin care products seem to reduce skin tear incidence. The suction blister method leads to the artificial and controlled separation of dermis and epidermis. Therefore, time to blister formation may be used as outcome measuring the strength of dermo‐epidermal adhesion. We conducted an exploratory, randomised, controlled trial with a split‐body design on forearms in healthy female subjects (n = 12; mean age 70.3 [SD 2.1] years). Forearms assigned to the intervention were treated twice daily with petrolatum for 8 weeks. Suction blisters were induced on forearms after 4 and 8 weeks and time to blister formation was measured. Stratum corneum and epidermal hydration were measured and epidermal thickness was assessed via optical coherence tomography. Time to blistering was longer and stratum corneum as well as epidermal hydration was consistently higher in intervention skin areas. We conclude that topical application of basic skin care products may improve mechanical adhesion of the dermo‐epidermal junction and that the parameter “time to blistering” is a suitable outcome to measure dermo‐epidermal adhesion strength in clinical research.
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Affiliation(s)
- Monira El Genedy-Kalyoncu
- Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia Richter
- Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Christian Surber
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Ulrike Blume-Peytavi
- Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jan Kottner
- Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, Berlin, Germany.,Charité Center for Health and Human Sciences, Charité-Universitätsmedizin Berlin, Berlin, Germany
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45
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Lukic M, Filipovic M, Pajic N, Lunter D, Bozic D, Savic S. Formulation of topical acidic products and acidification of the skin - Contribution of glycolic acid. Int J Cosmet Sci 2021; 43:419-431. [PMID: 33864274 DOI: 10.1111/ics.12707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The acidic skin pH is one of the regulating factors of skin barrier homeostasis. Topical products as extrinsic factors which influence skin pH could be used for acidification of the skin and consequent beneficial effect. To formulate stabile and safe topical emulsion product with low pH is on-going challenge and areas interesting to explore are related to the effect of acidic products on the skin pH together with development of protocols for these studies. Aim of our work was to investigate formulations of acidic topical products with glycolic acid (GA) stabilized with long chain alkyl polyglucoside emulsifier, in regard to the specific colloidal structure of the vehicle, together with effect of products with different concentration of acidic active on skin pH. METHODS Investigated formulations were basic vehicle and two creams with glycolic acid (concentration 2 and 10 wt%). Microstructure was investigated by polarization microscopy, Raman spectral imaging, thermal analysis and rheological measurements. Effects on the skin were assessed by measurement of biophysical skin parameters in vivo studies (5-hour, 24-hour and 7-days). In vitro screening of antimicrobial activity was performed against bacteria Staphylococcus epidermidis. RESULTS Polarization micrographs and Raman images have shown that GA does not disturb the specific colloidal structure. Together with rheological and thermal analysis obtained results have shown that GA in higher concentrations contributes to vehicles' lamellar structure. In 5-hour study the mean values of skin pH ranged from 3.98-4.25 and 3.89-4.10 after application of products with smaller and higher GA concentration. GA samples lowered skin surface pH to 5 and less in 24-hour and 7-day study, with stronger effect of sample with more GA. Sample with 10% of GA had significant inhibitory effect on growth of S. epidermidis in 1:1 concentration. CONCLUSIONS Investigated APG emulsifier could be used as a stabilizer for acidic topical products with GA which are characterized by satisfactory safety profile. Topical products induce acidification of the skin after short- and long-term application without barrier impairment or sign of irritation. Acidification of the skin depends on presence of ingredients which are proton donors and their concentrations.
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Affiliation(s)
- Milica Lukic
- Department of Pharmaceutical Technology and Cosmetology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Mila Filipovic
- Academy for Applied Studies Belgrade, College of Health Sciences, Belgrade, Serbia
| | - Nevena Pajic
- Department of Pharmaceutical Technology and Cosmetology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Dominique Lunter
- Department of Pharmaceutical Technology, Eberhard Karls University, Tuebingen, Germany
| | - Dragana Bozic
- Department of Microbiology and Immunology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Snezana Savic
- Department of Pharmaceutical Technology and Cosmetology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
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46
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Geriatrics and COVID-19. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1318:209-222. [PMID: 33973181 DOI: 10.1007/978-3-030-63761-3_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Since December 2019, a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has begun to infect people. The virus first occurred in Wuhan, China, but the whole world is now struggling with the pandemic. Over 13 million confirmed cases and 571,000 deaths have been reported so far, and this number is growing. Older people, who constitute a notable proportion of the world population, are at an increased risk of infection because of altered immunity and chronic comorbidities. Thus, appropriate health care is necessary to control fatalities and spread of the disease in this specific population. The chapter provides an overview of diagnostic methods, laboratory and imaging findings, clinical features, and management of COVID-19 in aged people. Possible mechanisms behind the behavior of SARS-CoV-2 in the elderly include immunosenescence and related impaired antiviral immunity, mature immunity and related hyper-inflammatory responses, comorbidities and their effects on the functioning of critical organs/systems, and the altered expression of angiotensin-converting enzyme 2 (ACE2) that acts as an entry receptor for SARS-CoV-2. This evidence defines the herding behavior of COVID-19 in relation to ACE2 under the influence of immune dysregulation. Then, identifying the immunogenetic factors that affect the disease susceptibility and severity and as well as key inflammatory pathways that have the potential to serve as therapeutic targets needs to remain an active area of research.
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47
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Glass GF, Goh CCK, Cheong RQ, Ong ZL, Khong PCB, Chan EY. Effectiveness of skin cleanser and protectant regimen on incontinence-associated dermatitis outcomes in acute care patients: A cluster randomised trial. Int Wound J 2021; 18:862-873. [PMID: 33960676 PMCID: PMC8613386 DOI: 10.1111/iwj.13588] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 02/04/2021] [Accepted: 03/09/2021] [Indexed: 01/13/2023] Open
Abstract
Skin cleansers and protectants protect skin from incontinent matter to reduce the risk of incontinence-associated dermatitis (IAD), but their effectiveness treating established IAD in the tropics is unknown. We conducted an open-label cluster randomised trial to compare the effectiveness of a combined regimen of (1) specialised skin cleansers with disposable body wipes and (2) either an acrylic terpolymer (T1) or zinc oxide (T2) skin protectant against disposable body wipes and zinc oxide protectant (control) in promoting IAD healing and reducing the risk of deterioration. Eighty-four patients were recruited in a tertiary hospital in Singapore between April 2019 and January 2020 (T1: n = 23; T2: n = 37; Control: n = 24). Although not statistically significant, patients treated with T1 and T2 were 1.5 times as likely to experience IAD healing within seven days compared with the control (P = .66). Healing was more pronounced in participants with skin loss treated with T1 or T2. No treatment was superior in preventing IAD deterioration, the prevalence of which remained small (8%-14%). While skin cleaning and protectants reduced the overall risk of skin deterioration, the addition of skin cleansers enhanced IAD healing within a short period, an important consideration for future research examining IAD treatment in acute care.
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Affiliation(s)
| | | | - Run Qi Cheong
- Nursing Research Unit, Tan Tock Seng Hospital, Singapore, Singapore
| | - Zhi Lei Ong
- Nursing Research Unit, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Ee-Yuee Chan
- Nursing Research Unit, Tan Tock Seng Hospital, Singapore, Singapore.,Alice Lee Centre of Nursing Studies, National University of Singapore, Singapore
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Dissemond J, Assenheimer B, Gerber V, Hintner M, Puntigam MJ, Kolbig N, Koller S, Kurz P, Läuchli S, Probst S, Protz K, Steiniger A, Strohal R, Traber J, Kottner J. Moisture-associated skin damage (MASD): A best practice recommendation from Wund-D.A.CH. J Dtsch Dermatol Ges 2021; 19:815-825. [PMID: 33942514 DOI: 10.1111/ddg.14388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/01/2020] [Indexed: 11/25/2022]
Abstract
Wund-D.A.CH., as the umbrella organization of German-speaking wound treatment societies, has currently developed a best practice recommendation for skin damage caused by body fluids, which is known as moisture-associated skin damage (MASD) in English-speaking countries. In this expert consensus, the diseases incontinence-associated dermatitis (IAD), intertriginous dermatitis, including intertrigo, gram-negative bacterial toe web infection and toxic contact dermatitis, including periwound and peristomal dermatitis are presented in a differentiated manner. A common feature of these clinical diseases is a deterioration of skin integrity due to prolonged exposure to body fluids such as urine, stool, sweat or wound exudate with associated physical-irritative and/or chemical irritation. In addition, other comorbidities and cofactors play an important role. The diagnosis of these interdisciplinary and interprofessionally relevant MASD is difficult in everyday clinical practice because there are currently no uniform definitions and many relevant differential diagnoses. Effective strategies for the prevention and therapy of these skin diseases are, for example, continence management, use of efficient, absorbent aids with good retention as well as consistent skin protection and adequate skin care. Another important aspect is the education of patients and relatives about the origin, treatment and prevention of MASD.
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Affiliation(s)
- Joachim Dissemond
- Department of Dermatology, Venereology and Allergology, University Hospital Essen, Germany
| | | | - Veronika Gerber
- Training and Consulting for Wound Management, Spelle, Germany
| | | | | | - Norbert Kolbig
- Office for Wound Management, University Hospital Düsseldorf, Germany
| | | | - Peter Kurz
- WPM Wound Care Management, Bad Pirawarth, Austria
| | - Severin Läuchli
- Dermatology Department, University Hospital, Zurich, Switzerland
| | | | - Kerstin Protz
- Institute for Health Services Research in Dermatology and Nursing, CWC - Comprehensive Wound Center, University Hospital Hamburg, Germany
| | | | - Robert Strohal
- Department of Dermatology and Venereology, State Hospital Feldkirch, Austria
| | - Jürg Traber
- Surgery/Vascular Surgery FEBVS, Phlebology SGP, Vein Hospital Bellevue, Kreuzlingen, Switzerland
| | - Jan Kottner
- Charité Centrum 1 for Human and Health Sciences, Charité -University Hospital Berlin, Germany
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49
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Lee J, Oh SJ, Park S, Park JH, Lee JH. Anti-pollution skincare: Research on effective ways to protect skin from particulate matter. Dermatol Ther 2021; 34:e14960. [PMID: 33884731 DOI: 10.1111/dth.14960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/28/2021] [Accepted: 04/19/2021] [Indexed: 10/21/2022]
Abstract
While there is increasing interest in anti-pollution care to particulate matter (PM), there has been no research evaluating the efficacy of skin care products in a real-world setting. Our objective was to find effective ways to protect skin from PM. In total, 64 volunteers whose skin was classified as reactive to PM concentration in the previous study were enrolled. Through split-face study, different combinations of skin care products (barrier cream, barrier cream/micellar water, antioxidant, and antioxidant/micellar water) were applied for 4 weeks during the high-PM period. The biophysical properties were measured, and a facial analysis system was used to evaluate skin condition at days 0, 14, and 28. The concentrations of PM and daily events that may affect skin conditions were also recorded. The mean concentration levels of PM10 and PM2.5 from days 0 to 14 were higher in the barrier cream group than in the antioxidant group. For each group, aside from skin tone in the antioxidant/micellar water group, there were no statistically significant differences in skin measurements before and after the application, which reflects no aggravation in skin condition during high-PM periods. Intergroup analysis showed no differences in skin measurements among the four groups from day 0 to day 14, from day 14 to day 28, and from day 0 to 28. For anti-pollution care, maintaining skin barrier function using barrier cream seems to be sufficient in individuals sensitive to PM.
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Affiliation(s)
- Jongeun Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Se Jin Oh
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sewon Park
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ji-Hye Park
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong Hee Lee
- Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Medical Device Management and Research, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, South Korea
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50
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Konya I, Nishiya K, Yano R. Effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults: A systematic review. Nurs Open 2021; 8:2284-2300. [PMID: 33724709 PMCID: PMC8363374 DOI: 10.1002/nop2.836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/29/2021] [Accepted: 02/16/2021] [Indexed: 12/27/2022] Open
Abstract
Aim To evaluate the effectiveness of bed bath methods for skin integrity, skin cleanliness and comfort enhancement in adults. Design A systematic review based on the PRISMA guidelines. Methods We searched for quantitative studies published between 2004–2020, using the PubMed, MEDLINE and CINAHL. The remaining 25 studies were appraised by the JBI tool. Results Only four of the included studies were of high quality. Studies of above moderate quality demonstrated that disposable towels were as effective as cotton towels for skin lesions and bacterial removal. Applying a hot towel maintained the skin barrier function and provided warmth; cotton towels were effective for cleaning even with weak pressure, and post‐bed bath moisturizer treatment contributed to skin integrity. Conclusion Although various methods have been examined, the available evidence is inadequate for establishing best practices. It is necessary to verify empirical research with rigorous methodology involving elderly inpatients and to develop instruments that measure patients' comfort.
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Affiliation(s)
- Issei Konya
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Kotone Nishiya
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Rika Yano
- Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
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