Effect of semipermeable membranes on skin barrier repair following tape stripping

Visscher, Marty O.; Hoath, Steven B.; Conroy, Eileen; Wickett, R. Randall

doi:10.1007/pl00007463

Cited by 65 publications

(60 citation statements)

References 25 publications

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“…28 Occlusive films significantly delayed SC barrier repair following tape stripping relative to semipermeable dressings and no occlusion. 29 Increased SC hydration leads to maceration, lipid bilayer disruption, formation of amorphous intercellular regions and degradation of the corneodesmosomes. [30][31][32] Long-term occlusion of stripped skin caused loss of the epidermal Ca þ 2 gradient required for lipid synthesis, regulation of epidermal cell proliferation and differentiation to delay SC barrier recovery.…”

Section: Discussionmentioning

confidence: 99%

Effect of chlorhexidine gluconate on the skin integrity at PICC line sites

et al. 2009

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Objective: To determine the effects of chlorhexidine gluconate (CHG) on skin inflammation and stratum corneum barrier integrity at peripherally inserted central catheter (PICC) sites among patients in the neonatal intensive care setting.Study Design: In a within-subject design, PICC sites with CHG plus semipermeable dressing (PICC) were compared with contralateral dressing sites and untreated controls among 40 neonates (gestational age 32.1 ± 4.7) at weekly dressing changes, using quantitative measures of skin erythema, dryness and barrier integrity (transepidermal water loss, TEWL). Data were analyzed using analysis of variance and linear mixed methods.Results: At week 1, all three sites differed for erythema with the highest value indicating poorer skin condition at the PICC site. Dressing-site erythema was higher than the untreated control. Dryness and TEWL were higher, indicating poorer skin integrity, for the PICC site than either the dressing or the control. After 2 weeks, erythema and dryness scores were higher for the PICC site than the dressing and control skin. By week 3, scores were comparable for PICC and dressing sites and both were higher than the control for erythema and dryness. After 3 weeks, PICC skin TEWL was higher than both dressing and control and they did not differ from each other. Conclusion:The dressings used to secure PICC lines contribute to the observed skin compromise at CHG-treated skin sites and may affect skin barrier development in similar populations of neonates.

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Section: Discussionmentioning

confidence: 99%

Effect of chlorhexidine gluconate on the skin integrity at PICC line sites

et al. 2009

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“…Once epidermal stripping has occurred, management strategies to promote reepithelialization may include application of barrier ointment or cyanoacrylate liquid or application of a transparent film dressing. 37 Surgical wounds. Surgical wounds are common in the pediatric population, yet there are no clear guidelines for routine postoperative management (Fig.…”

Section: Wound Management Issues In Pediatricsmentioning

confidence: 99%

Dressings and Products in Pediatric Wound Care

King

Stellar

Blevins

et al. 2014

Advances in Wound Care

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Significance: The increasing complexity of medical and surgical care provided to pediatric patients has resulted in a population at significant risk for complications such as pressure ulcers, nonhealing surgical wounds, and moistureassociated skin damage. Wound care practices for neonatal and pediatric patients, including the choice of specific dressings or other wound care products, are currently based on a combination of provider experience and preference and a small number of published clinical guidelines based on expert opinion; rigorous evidence-based clinical guidelines for wound management in these populations is lacking. Recent Advances: Advances in the understanding of the pathophysiology of wound healing have contributed to an ever-increasing number of specialized wound care products, most of which are predominantly marketed to adult patients and that have not been evaluated for safety and efficacy in the neonatal and pediatric populations. This review aims to discuss the available data on the use of both more traditional wound care products and newer wound care technologies in these populations, including medical-grade honey, nanocrystalline silver, and soft silicone-based adhesive technology. Critical Issues: Evidence-based wound care practices and demonstration of the safety, efficacy, and appropriate utilization of available wound care dressings and products in the neonatal and pediatric populations should be established to address specific concerns regarding wound management in these populations. Future Directions: The creation and implementation of evidence-based guidelines for the treatment of common wounds in the neonatal and pediatric populations is essential. In addition to an evaluation of currently marketed wound care dressings and products used in the adult population, newer wound care technologies should also be evaluated for use in neonates and children. In addition, further investigation of the specific pathophysiology of wound healing in neonates and children is indicated to promote the development of wound care dressings and products with specific applications in these populations. SCOPE AND SIGNIFICANCEGiven the lack of consensus on the optimal strategies for common wound care management issues in the neonatal and pediatric populations and the large number of wound care products on the market today, it can be challenging to make informed decisions regarding wound care in these populations. A comprehensive review of the literature on the following specific areas of focus: pressure ulcers, surgical wounds, epidermal stripping, intravenous extravasation injuries, moisture-associated skin damage (MASD), and use of negative-pressure wound therapy (NPWT) is presented, along with management recommendations based on the clinical experience of the authors.

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“…The neutral skin surface pH of human infants was first noted by Taddei (1935), and Behrendt and Green detailed the kinetics of development of an acidic surface pH over the first postnatal month (1958). Since the skin surface pH of both full-term and premature infants acidifies rapidly during the first week (Fox et al, 1998;Visscher et al, 2001), the progressive postnatal adaptation of SC pH to ex-utcro conditions occurs independent of fetal age at birth.…”

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confidence: 99%