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Alsatari ES, AlSheyab N, D'Sa JL, Gharaibeh H, Eid S, Al-Nusour EA, Hayajneh AA. Effects of argan spinosa oil in the treatment of diaper dermatitis in infants and toddlers: A quasi-experimental study. J Taibah Univ Med Sci 2023; 18:1288-1298. [PMID: 37275956 PMCID: PMC10239066 DOI: 10.1016/j.jtumed.2023.05.008] [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: 12/28/2022] [Revised: 04/20/2023] [Accepted: 05/10/2023] [Indexed: 06/07/2023] Open
Abstract
Objectives Diaper dermatitis (DD) is one of the most common dermatological disorders in children. Commonly used drugs for treatment have several adverse effects; therefore, assessment of safe therapeutic strategies is necessary. We, therefore, aimed at comparing the efficacy of argan spinosa oil and 1% hydrocortisone ointment on DD healing. Methods A quasi-experimental study was conducted in Jordan on children 2 years old or younger with mild to severe DD. Initially, 73 participants were enrolled in the argan spinosa oil group, and 74 participants were enrolled in the 1% hydrocortisone ointment group. Participants were assigned to groups randomly after the baseline measurement of DD. Healing was measured on a 5-point scale on days 1, 3, and 7, through home visits. Data were analyzed with Fisher's exact test, the Mann-Whitney U test, and generalized estimating equation (GEE) models in SPSS version 25 software, with a significance level of p < 0.05. Results Of the 147 enrolled children, 140 completed the study. A significant decrease in the DD grades was observed in both groups. After the exclusion of confounding factors, the GEE models revealed that children treated with argan spinosa oil were approximately 0.25 times less likely to have severe DD grades and to show faster improvement than children treated with 1% hydrocortisone (p < 0.025). Multiple logistic regression on the baseline data revealed that the use of barrier cream (OR: 0.35; 95% CI: 0.18, 0.72; p = 0.004) and a frequency of bathing one or fewer times per week (OR: 1.15; 95% CI: 0.65, 2.10; p = 0.002) predicted DD occurrence. Conclusion Argan spinosa oil is more effective than 1% hydrocortisone in healing DD and might be used as a complementary treatment. However, further clinical trials on larger samples will be essential for confirming the results and making a reliable judgment. Trial registration NCT04210674.
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Affiliation(s)
- Eman S. Alsatari
- Department of Nursing Education and Development, King Saud University Medical City, Riyadh, KSA
| | - Nihaya AlSheyab
- Department of Maternal and Child Health Nursing, Faculty of Nursing/Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Juliana L. D'Sa
- Department of Maternal and Child Health Nursing, College of Nursing, King Saud University, Riyadh, KSA
| | - Huda Gharaibeh
- Department of Maternal and Child Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Sami Eid
- Department of Nursing Education and Development, King Saud University Medical City, Riyadh, KSA
| | - Esra'a A. Al-Nusour
- Department of Paramedics, Prince Al Hussein Bin Abdullah II Academy for Civil Protection, AlBalqa Applied University, Salt, Jordan
| | - Audai A. Hayajneh
- Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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A new therapeutic horizon in diaper dermatitis: Novel agents with novel action. Int J Womens Dermatol 2021; 7:466-470. [PMID: 34621960 PMCID: PMC8484940 DOI: 10.1016/j.ijwd.2021.02.003] [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: 07/16/2020] [Revised: 01/20/2021] [Accepted: 02/07/2021] [Indexed: 01/19/2023] Open
Abstract
Objective This review looks at novel combinations of topical agents (i.e., zinc gluconate, zinc oxide, dexpanthenol, and taurine) that target a combination of mechanisms in diaper dermatitis. Methods A literature search of published studies was conducted using the search terms "diaper dermatitis", "treatment of diaper dermatitis in infants", "treatment of diaper dermatitis in adults", "nonsteroidal", "nonantibiotic", "antiinflammatory", "moisturizer", and "treatment for irritation". A total of 207 related articles were screened, and those categorized as clinical trials and reviews were studied and compared. Articles with common themes were categorized, summarized, and presented herein. Results Diaper dermatitis, also referred to as diaper rash, napkin dermatitis, and nappy rash, is the most common skin eruption in infants and toddlers. In the last several years, there have been several technologic advances in diaper design to lessen the severity of diaper dermatitis symptoms. However, due to the unique environment of the diaper area, children and adults continue to have recurring symptoms of diaper dermatitis. Both commercially available products and certain home remedies are considered effective for managing sensitive and delicate skin in the diaper area. These topical agents create a protective barrier over the skin and reduce the impact of external irritants, which cause the reddening and burning sensation often associated with diaper dermatitis. Conclusion A range of therapeutic strategies for preventing and controlling diaper dermatitis are summarized in this manuscript.
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Novitasari PD, Wanda D. Evidence-based nursing intervention to reduce skin integrity impairment in children with diaper dermatitis: A systematic review. LA PEDIATRIA MEDICA E CHIRURGICA 2021; 43. [PMID: 37184326 DOI: 10.4081/pmc.2021.265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Indexed: 11/22/2022] Open
Abstract
Diaper dermatitis often occurs in children. In Indonesia, the guidelines for managing this health problem are issued by each hospital in Indonesia, but there are no guidelines for formal prevention and management released by the Indonesian Health Ministry. This study aimed to propose the Air, Barrier, Cleansing, Diapering, Education (ABCDE) approach as an evidence-based independent nursing intervention to prevent and treat impaired skin integrity, particularly diaper dermatitis, in children by nurses. This systematic review was derived from multiple databases using the following keywords: “child,” “diaper dermatitis,” “diaper-free time,” “air,” "barrier,” “cleansing,” “diaper,” and “education.” From these keywords, 393 articles were collected and then filtered using inclusion and exclusion criteria to obtain the final articles to be analyzed. Thirty-one articles passed the criteria. The study found that the ABCDE approach was effective in preventing and treating diaper dermatitis in children. Its indicators of the approach were preventing or decreasing inflammation, repairing damage to the skin, and preventing reoccurrence. Based on the review and analysis of multiple aspects in Indonesia, the authors proposed a modification of the sequence to CBAD-E to implement the approach in Indonesian children. The intervention of the ABCDE approach matches Indonesian children’s situation, and therefore it can be implemented in Indonesia. Accordingly, this recommendation may be useful and feasible to be implemented by nurses in preventing and treating diaper dermatitis in children, thus decreasing its prevalence.
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An Integrative Review of Clinical Characteristics of Infants With Diaper Dermatitis. Adv Neonatal Care 2020; 20:276-285. [PMID: 31895136 DOI: 10.1097/anc.0000000000000682] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Diaper dermatitis (DD) severity is demonstrated by the degree of erythema and skin breakdown. Many studies describe diaper dermatitis, but lack a full description of clinical characteristic (CC) involvement. PURPOSE The purpose of this literature review is to explore the descriptions of CC of infants with DD provided within infant DD literature. SEARCH STRATEGY PubMed and Web of Science were searched using the keywords: diaper dermatitis, diaper rash, infant, and neonate. The inclusion criteria for this project are as follows: published after 1990, English language, include skin assessment or evaluation, and infant/children < two years of age. Review and opinion articles were excluded. RESULTS A total of 454 studies were retrieved, 27 remained after review for duplicates and relevance. The CC described most often were: type of feeds, stool frequency, history of DD, use of antibiotics, and delivery mode. SYNTHESIS OF EVIDENCE The studies reported inconsistent CC and a lack of correlation between these characteristics and the condition of diapered skin. Many studies focused solely on the efficacy of interventions lacking description of possible relationships between DD and CC. IMPLICATIONS FOR PRACTICE Skin condition outcome variables can be improved with the acknowledgment of the impact CC have on the development of DD. The combination of assessment measures and CC may ultimately demonstrate more merit or rigor for describing DD severity and skin condition. IMPLICATIONS FOR RESEARCH Future research should expand this exploration to include environmental or contributing factors to continue to identify additional risk factors for DD.
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Niazi M, Mehrabani M, Namazi MR, Salmanpour M, Heydari M, Karami MM, Parvizi MM, Fatemi I, Mehrbani M. Efficacy of a topical formulation of henna (Lawsonia inermis L.) in contact dermatitis in patients using prosthesis: A double-blind randomized placebo-controlled clinical trial. Complement Ther Med 2020; 49:102316. [PMID: 32147071 DOI: 10.1016/j.ctim.2020.102316] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 01/09/2020] [Accepted: 01/13/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Contact dermatitis is a common complication in prosthetic limb users. There are no effective, available and cheap treatments for skin problems of these patients. In traditional Iranian medicine, henna (Lawsonia inermis L.) is a plant that has anti-inflammatory, antimicrobial and skin-enhancing properties, all of which are beneficial for people with artificial limbs. The aim of this study was to assess the efficacy of a topical henna preparation in management of contact dermatitis in patients using lower limb prosthetics. METHODS The current randomized, double-blind, placebo-controlled clinical trial was conducted on ninety-five participants with lower extremity amputation using limb prosthetics, aged 12-70 years who complained of contact dermatitis. They were randomly assigned to receive either two weeks of topical henna preparation every night as the intervention group, or topical placebo as the control group. Participants were instructed to spread henna preparation on the surfaces of the amputated limb that were in contact with the prosthesis. Severity of contact dermatitis symptoms was set as the primary outcome measure. Edema, papules and erythema were evaluated by a physician using standard color atlas. Secondary outcomes included symptoms such as burning, itching, pain, thickness and skin sweating evaluated by a self-administered questionnaire. RESULTS A significant improvement was observed in the symptoms of contact dermatitis including skin edema, itching, sweating, skin thinning and pain (p-value<0.05) in the henna group compared to the placebo group. Skin burning decreased more in the henna group compared to the placebo group, but this was not statistically significant (p-value = 0.052). Moreover, skin redness significantly increased in the henna group (p-value = 0.001). CONCLUSION Topical formulation of henna might be a complementary choice for improving contact dermatitis in patients using lower limb prosthetics.
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Affiliation(s)
- Mehdi Niazi
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran; Department of Traditional Medicine, Faculty of Traditional Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Mitra Mehrabani
- Herbal and Traditional Medicines Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Namazi
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Salmanpour
- Center for Nanotechnology in Drug Delivery, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Pharmaceutics, Shiraz School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Heydari
- Pharmaceutical Sciences Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mohammad Mahdi Parvizi
- Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Fatemi
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrzad Mehrbani
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran.
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Prevention and Management of Incontinence-Associated Dermatitis in the Pediatric Population: An Integrative Review. J Wound Ostomy Continence Nurs 2019; 46:30-37. [PMID: 30608338 DOI: 10.1097/won.0000000000000490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
An integrative review was conducted to synthesize evidence on prevention and management of incontinence-associated dermatitis (IAD) in the pediatric population. A 5-step integrative process was used to guide the review. Articles published from January 2000 to April 6, 2017, were identified and retrieved from CINAHL, PubMed, ProQuest (MEDLINE), and Scopus; key terms were associated with IAD, pediatric, prevention, and management. Supplemental and manual searches were carried out to identify other relevant studies. The studies' findings were extracted and summarized in a table of evidence, with their quality evaluated using the Joanna Briggs Institute's Critical Appraisal Checklist. Sixteen articles were included in the review. Articles explored prevention and management strategies including skin cleansing technique, diaper selection, and the application of topical skin care products. Inconsistent and limited evidence was found regarding the benefits of using disposable wipes in preference to water-moistened washcloths in the cleansing process and on the use of superabsorbent polymer diapers with breathable outer lining in IAD prevention. Findings were inconclusive with regard to the best topical skin care product for IAD care. However, the application of skin protectants was encouraged by the authors, as well as promoted in various clinical guidelines. The development of a structured skin care regimen supplemented by a comprehensive patient education program was advised to enhance the prevention and management of IAD.
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Rafiei Z, Mazaheri M, Eghbali-Babadi M, Yazdannik A. The Effect of Henna ( Lawsonia Inermis) on Preventing the Development of Pressure Ulcer Grade One in Intensive Care Unit Patients. Int J Prev Med 2019; 10:26. [PMID: 30967912 PMCID: PMC6413520 DOI: 10.4103/ijpvm.ijpvm_286_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 09/10/2017] [Indexed: 11/04/2022] Open
Abstract
Background Detecting pressure ulcer is an important nursing diagnostic and care requirement in patients hospitalized in Intensive Care Unit (ICU). The purpose of this study is to examine the effect of Lawsonia plant on pressure ulcer grade one in ICU patients. Methods In this clinical trial, 72 patients eligible for hospitalization in hospitals of Isfahan University of Medical Sciences were divided randomly into two control and intervention groups. The standard program of skin care was implemented on both groups; in addition, a mixture of Lawsonia (henna) and distilled water was applied topically in the intervention group. The classification form of the International Pressure Ulcer Advisory Panel was used to identify grade one ulcers. Data were collected on the 1st day through demographic information questionnaire and Braden pressure ulcer risk assessment scale. An infrared thermometer was used to record local temperature of the ulcers on a daily basis. Assessments were made based on Pressure Ulcer Scale for Healing (PUSH), and the pressure ulcer area was examined per square centimeter on the 1st, 4th, and 7th days. The data were analyzed using SPSS 16. Results The average change in the ulcer area per square centimeter in the control group increased by 29.9 ± 37.93 whereas it decreased by 3.54 ± 33.91 in the intervention group. The mean PUSH score decreased in the intervention group (5.36 ± 3.12) while it increased in the control group (1.91 ± 1.53). The average changes of PUSH score before and after the intervention showed a significant difference in both groups. Conclusions With regard to the effect of henna on the reduction of ulcer area and the average PUSH score in ICU patients, the application of henna is recommended for healing grade one pressure ulcers.
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Affiliation(s)
- Zahra Rafiei
- Department of Critical Care Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Mazaheri
- Department of Traditional Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Eghbali-Babadi
- Nursing and Midwifery Care Research Center, Department of Critical Care, Nursing and Midwifery School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmadreza Yazdannik
- Nursing and Midwifery Care Research Center, Department of Critical Care, Nursing and Midwifery School, Isfahan University of Medical Sciences, Isfahan, Iran
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