A new skin protectant was developed for use on conditions involving partial-thickness skin loss such as severe incontinence-associated dermatitis. This new formulation is based on a cyanoacrylate chemistry designed to polymerize in situ and create a breathable film able to protect the skin surface from external irritants. This film provides an environment favorable for healing to occur beneath the film. To evaluate the characteristics of the novel chemistry, we devised a preclinical testing strategy comprising three different animal models. The data from all three models was considered collectively to create an overall assessment of effectiveness. A guinea pig model was used to evaluate the barrier efficacy of the new product in protecting intact skin from irritation. A porcine partial-thickness wound model was used to evaluate the efficacy of the product in helping control minor bleeding and exudate. A similar model was also used to assess the process of reepithelialization in the continued presence of an irritant. In the first model, untreated sites had 8.5 times more irritation than sites covered with the new product (p < 0.001). In the second model, a single application of the new product successfully attached to intact peri-wound skin and to denuded, weepy skin. It significantly reduced the amount of fluid weeping from the wounds (p 0.001) and continued to perform throughout a 96 hours experiment. In the third model, the percent of reepithelialization was significantly greater for the wounds covered with the new product than for the control wounds (p 5 0.003; on average, 18.3% greater, with a 95% confidence interval of 9.2% to 27.5%). These results suggest that the new skin protectant protects intact and denuded skin from irritants and provides an environment favorable to healing, offering promise for the management of various conditions involving loss of epidermis. Wound healing is a complex biological process with several steps involved to restore skin integrity (hemostasis, inflammation, granulation tissue formation, and remodel-ing). The biological events involved and how they can be modulated using current knowledge and technology have been recently reviewed by Wong et al. 1 The context of the wound impacts the sequence of events that will follow and the successful resolution of the wound. A variety of products are available to manage wounds. Dressings are typically used for acute (surgical or traumatic) and chronic wounds (recently reviewed by Sood et al. 2); however, severe skin damage such as that seen in incontinence-associated dermatitis (IAD) requires a different approach due to the location on the body and the necessity for frequent cleaning caused by incontinence episodes. In mild cases of IAD (skin is red and macerated but epidermis is still present), barrier films can be used. These products are applied as liquids, either in a spray formulation, a wipe, or a wand applicator, and polymerize to form a film in situ and protect the skin. In severe cases of IAD, however , the epidermis is breached...
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