pH, Temperature, Hydration of the Stratum Corneum of the Dorsal Hand and the Cord Area, and Acid Mantle Formation during Early Days of life in High-risk Newborns

Ahn, Youngmee; Sohn, Min; Lee, Sangmi; Lee, Mi-Jin

doi:10.4040/jkan.2013.43.1.30

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…The infants in the AM-yes group had a greater gestational age and BW than those in the AM-no group, which might explain this observation. This possibility is supported by our previous study [13], as well as that of https://doi.org/10.4094/chnr.2018.24.3.345…”

Section: Chnrsupporting

confidence: 81%

“…Furthermore, Visscher et al [12] reported that SCH tended to plateau at 10~15 days in both the diapered and non-diapered regions in term newborns. In our previous studies [13], the hydration level in premature newborns ranged from 32.7% to 33.9% at 7 days of life in premature infants, while the hydration level was 36.4% at 15.3 days of life in premature newborns and 34.1% at 10.3 days in full-term newborns. Similarly, in our current study, while SCH ranged from the 20% to 60% range on the first day, it decreased or increased to converge in the 30% range by 2 weeks of life.…”

Section: Discussionmentioning

confidence: 74%

“…A study of healthy preterm newborns (gestational days: 212~257) reported that the SCP was 5.65 on the second day and 5.47 at the second week of life at the upper leg, and 5.31 on the second day and 5.16 at the second week of life at the forehead [16]. Our previous study [13] reported a similar pH value (5.48 on the dorsal hand) and that 57.1% of subjects had formed an AM by the seventh day of life. These findings indicate the possibility of wide pH ranges in the SC according to the measurement site and depending on the clinical conditions of newborns.…”

Section: Discussionmentioning

confidence: 87%

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Hydration and pH of the Stratum Corneum in High-risk Newborns in the First 2 Weeks of Life

Ahn¹,

Sohn²,

Lee³

2018

Child Health Nurs Res

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The study was conducted to measure stratum corneum hydration (SCH) and pH (SCP) in high-risk newborns in the early postnatal period and to explore the features related to patterns of change in those parameters. Methods: SCH and SCP were measured on the dorsal hand in 99 hospitalized newborns during the first 14 days of life and the results were analyzed using a general linear model. Results: The mean hydration was 42.9% on day 1, which decreased to 34.6% by 2 weeks (F=15.61, p=<.001). An association was observed between SCH and prematurity (F=21.12, p<.001), as well as for their interaction (F=8.11, p<.001). The mean SCP was 6.2±0.3 on day 1, and decreased to 5.7±0.2 (F=95.75, p<.001), with no association with prematurity. After adjusting for birth weight, SCH was higher in newborns with vaginal delivery (F=9.07, p=.023) and who received phototherapy (F=11.81, p=.011). For SCP, only delivery type had a significant influence (F=6.40, p=.044). Conclusion: This study suggests that SCH is typically in the 30% range during the early postnatal period, and that an acid mantle on the SC surface is very unlikely to form; these findings could be applied to the nursing process for promoting skin integrity in high-risk neonates.

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Section: Chnrsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 87%

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Hydration and pH of the Stratum Corneum in High-risk Newborns in the First 2 Weeks of Life

Ahn¹,

Sohn²,

Lee³

2018

Child Health Nurs Res

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“…Similarly, previous research found no change in hydration between tap water cleansing and detergent cleansing in healthy infants (Gfatter et al, 1997). For skin temperature of the cord area, Ahn et al (2013) reported no changes before cord detachment in high-risk newborns, regardless of various environmental exposures such as bed types. For pH, the degree of variation across study days between groups seemed too trivial (.09 maximum at day 5) to infer clinical meaning consistent with other findings that have shown that cleansing with water seems comparable with cleansing with other supplements on skin acidification for newborns (Blume-Peytavi et al, 2012; Garcia Bartels et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Healthy skin, including the cord area, involves maintaining proper hydration, temperature, and pH and colonization of normal floras at the surface. A study of high-risk infants reported that the hydration and temperature of the skin surface are critical indicators in assessing the quality of fluid balance, systemic circulation, and central and peripheral thermoregulation (Ahn et al, 2013). Additionally, the keratinization process of the stratum corneum (SC) is related to the pH change and floras colonizing the external surface of the epidermis as part of extrauterine adaptation (Hoeger and Enzmann, 2002; Mancini, 2004).…”

Section: Introductionmentioning

confidence: 99%

Two methods of cord care in high-risk newborns

Ahn

Sohn

Jun

et al. 2013

J Child Health Care

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This randomized clinical study explored the effects of two cord care methods on hydration, temperature, pH, and floras at the cord area in high-risk newborns. One group used the water method; and the other group used the alcohol method. Seventy-two newborns, including premature newborns, in the neonatal intensive care unit (NICU) of a university-affiliated hospital in South Korea were enrolled from August 2011 to May 2012. Hydration, temperature, pH, and floras were measured daily until the cords fell off. The results showed no difference between the groups in hydration, temperature, pH, and the colonization of floras, but cord detachment in the alcohol group took 2 days longer (12.8 [5.7] days) than in the water group (10.9 [4.1] days). Our findings suggest that the clean-and-dry method of cord care, which uses water, could be sufficient, possibly even better than alcohol in maintaining the physiologic surface milieu of the cord area with less chance of infection and manipulation in NICUs with optimal infection control.

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Development of a Nursing Guideline for Improving Skin Integrity in High-Risk Infants

Ahn¹,

Lee²,

Cho³

2020

J Contin Educ Nurs

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Background: High-risk infants are highly susceptible to skin impairment caused by invasive procedures, radiant warmers, and phototherapy, in addition to their intrinsic vulnerability. This leads to a vicious cycle that aggravates the risk of skin infections. Concerns have been raised that neonatal nurses may lack knowledge regarding feasible guidelines to improve skin integrity of high-risk newborns. Method: A clinical guideline was developed for neonatal skin care practices based on skin physiology, and its educational effects on the knowledge and confidence of neonatal nurses was evaluated. A booklet was developed on skin care practice guidelines divided into topics determined through a nationwide survey. Results: Using a quasi-experimental design with 46 neonatal nurses, education with this booklet improved nurses' knowledge of skin care practices but not their confidence. Conclusion: These findings highlight the importance of implementing a tailored systematic program rather than a single educational session on skin care in high-risk infants for neonatal nurses. [ J Contin Educ Nurs . 2020;51(5):238–244.]

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pH, Temperature, Hydration of the Stratum Corneum of the Dorsal Hand and the Cord Area, and Acid Mantle Formation during Early Days of life in High-risk Newborns

Cited by 5 publications

References 17 publications

Hydration and pH of the Stratum Corneum in High-risk Newborns in the First 2 Weeks of Life

Hydration and pH of the Stratum Corneum in High-risk Newborns in the First 2 Weeks of Life

Two methods of cord care in high-risk newborns

Development of a Nursing Guideline for Improving Skin Integrity in High-Risk Infants

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