Skin Occlusion: Treatment or Drug-Like Device?

Berardesca, Enzo; Maibach, Howard I.

doi:10.1159/000210775

Cited by 29 publications

(18 citation statements)

References 20 publications

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“…This finding may have various explanations. After 3 h in a surgical glove the microbial density on the skin depends on various factors, like the distribution and abundance of skin bacteria (14) and the number and activity of sweat and sebaceous glands, which may bring up more resident skin bacteria out of the ducts onto the stratum corneum (2,17). Although the sweat glands do not contain any bacteria themselves (19), the ducts of the sweat glands do.…”

Section: Discussionmentioning

confidence: 99%

Influence of Applied Volume on Efficacy of 3-Minute Surgical Reference Disinfection Method prEN 12791

Kampf

Ostermeyer

2004

Appl Environ Microbiol

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For assessment of the efficacy of surgical hand disinfection, European reference method prEN 12791 prescribes that the hands must be kept wet with the reference alcohol for 3 min regardless of the applied volume. The aim of this study was to determine whether the applied volume of the reference disinfectant n-propanol (60%, vol/vol) influences the effect on the resident hand flora. Ten experiments with 200 reference disinfections were analyzed. Hands were washed for 1 min with soap. The bacterial prevalue was obtained by rubbing fingertips in tryptic soy broth for 1 min. After this, each subject treated the hands with n-propanol (60%, vol/vol) by using as many portions as necessary to keep hands wet for a total of 3 min. Bacterial postvalues (immediate effect) were obtained for one hand, and the other hand was gloved for 3 h. After the gloves were taken off, a second postvalue was obtained (sustained effect). Most surgical reference disinfections (73%) were achieved with 9 ml of the reference alcohol, followed by 12 ml (24%) and 6 ml (3%). There was no significant difference between the mean log 10 reduction values for the three treatment groups, both in terms of the immediate effect (P ‫؍‬ 0.333, as determined by analysis of variance) and in terms of the sustained effect (P ‫؍‬ 0.442). A higher number of portions did not correlate with a higher reduction factor (for immediate effect, Pearson's correlation coefficient ‫؍‬ ؊0.028 [P ‫؍‬ 0.689]; for sustained effect, Pearson's correlation coefficient ‫؍‬ 0.059 [P ‫؍‬ 0.404]). If the hands were kept wet with the reference alcohol for the total application time, the applied volume could vary, but this did not alter the efficacy.

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Section: Discussionmentioning

confidence: 99%

Influence of Applied Volume on Efficacy of 3-Minute Surgical Reference Disinfection Method prEN 12791

Kampf

Ostermeyer

2004

Appl Environ Microbiol

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“…In addition, certain topical vehicles that contain fats and/or polymers oils (petrolatum, paraffin, etc.) may also generate occlusive effects (2).…”

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confidence: 99%

“…Many gloves do not resist the penetration of low molecular weight chemicals: those chemicals may enter the glove and become trapped on the skin under occlusion for many hours, possibly leading to irritation, and more seriously, to dermatitis or eczematous changes (13)(14)(15). Wound dressings have been employed to speed the healing processes in acute and chronic wounds by keeping healing tissues moist and increasing superficial wound epithelialization (2,16,17). However, occlusive or semiocclusive dressings can increase microorganisms and hence induce wound infections (2,(18)(19)(20)(21).…”

mentioning

confidence: 99%

“…Wound dressings have been employed to speed the healing processes in acute and chronic wounds by keeping healing tissues moist and increasing superficial wound epithelialization (2,16,17). However, occlusive or semiocclusive dressings can increase microorganisms and hence induce wound infections (2,(18)(19)(20)(21). A significant increase in the density of Staphylococcus aureus and lipophilic diphtheroids were observed after 24 h occlusion in eczematous and psoriatic skin (19).…”

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confidence: 99%

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Occlusion vs. skin barrier function

Zhai

Maibach

2002

Skin Research and Technology

171

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Background/aims: Skin occlusion may increase percutaneous absorption of applied chemicals, with some exceptions. It also obstructs the normal ventilation of the skin surface and increases stratum corneum hydration and hence compromises skin barrier function. Methods/results: This review focuses the effects of occlusion on skin barrier function, in particularly, as defined with objective skin bioengineering technology. Conclusions: The effects of occlusion on skin barrier function have been defined with various techniques. Optimal hydrocolloid materials can absorb excess water and reduce the unfavourable effects of occlusion.

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“…Certain topical vehicles, e.g. petrolatum or paraffin, contain fats and/or polymer oils that may generate occlusive effects by reducing water loss [2]. The epidermis of healthy skin provides an efficient barrier against the infiltration of exogenous and potentially harmful substances, and the stratum corneum typically has a water content of 10–20%.…”

Section: Introductionmentioning

confidence: 99%

Occlusion Effect on in vivo Percutaneous Penetration of Chemicals in Man and Monkey: Partition Coefficient Effects

Hafeez

Maibach²

2013

Skin Pharmacol Physiol

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Background/Aim: Skin occlusion can increase the hydration of the stratum corneum up to 50%, which can have substantial effects on the percutaneous absorption of penetrants by altering skin barrier physiology. Though occlusion is widely utilized to enhance the penetration of applied drugs in clinical practice, it is not well known for which chemicals occlusion enhances the penetration through skin. In this review, we focus on what effect occlusion has on the percutaneous absorption of compounds of varying lipophilicities/hydrophilicities in vivo in the monkey and man. Methods: Studies and prior reviews of the effects of occlusion on the in vivo percutaneous penetration of penetrants of varying liphophilicities/hydrophilicities were identified in the Medline, Pubmed, Embase and Science Citation Index databases. Results: After examining the research articles generated by the search results, 7 original research studies were obtained that used in vivo occlusion models and provided insight regarding the role of partition coefficients in predicting the effects of occlusion on percutaneous penetration. From these studies, one can conclude the following: (1) occlusion enhances the percutaneous absorption of many but not all compounds, (2) penetration can increase as the amount of time of occlusion increases, (3) occlusion seems to enhance the penetration of very lipophilic compounds more than that of very hydrophilic compounds, but (4) a relationship between a compound’s octanol-water partition coefficient and its occlusion-induced enhancement has not been determined. Conclusion: These in vivo studies reinforce the conclusions drawn from in vitro studies that partition coefficients incompletely predict the effect of occlusion on percutaneous penetration.

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Skin Occlusion: Treatment or Drug-Like Device?

Cited by 29 publications

References 20 publications

Influence of Applied Volume on Efficacy of 3-Minute Surgical Reference Disinfection Method prEN 12791

Influence of Applied Volume on Efficacy of 3-Minute Surgical Reference Disinfection Method prEN 12791

Occlusion vs. skin barrier function

Occlusion Effect on in vivo Percutaneous Penetration of Chemicals in Man and Monkey: Partition Coefficient Effects

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