skin-care-5.matches: skin care
Elderly skin care: principles of chronic wound care.

Frantz RA, Gardner S.

1. Chronic wounds are a frequently encountered problem in elders. Chronic wounds are characterized by loss of skin or underlying soft tissue and do not progress toward healing with conventional wound care treatment. 2. There are four basic principles of chronic wound care: remove debris and cleanse the wound; provide a moist wound healing environment through the use of proper dressings; protect the wound from further injury; and provide substrates essential to the wound healing process. 3. Underlying the care of chronic wounds is the necessity to assess the wound on an ongoing basis. Changes in wound care must be based on changing wound parameters, and timely, complete, and accurate wound assessments must be documented.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7930396&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Quantitative in vitro assessment of phototoxicity using a human skin model, Skin2.

Edwards SM, Donnelly TA, Sayre RM, Rheins LA, Spielmann H, Liebsch M.

Advanced Tissue Sciences, Inc., La Jolla, California 92037-1005.

The ability to accurately predict the phototoxic potential of personal and skin care products remains a key element in assessing the safety of premarketed products. To find a reliable in vitro alternative test for photoirritancy, the European Commission and the European Cosmetic Association are conducting a 3-year, European validation study. Based on the results of this study, an in vitro photoirritancy method will be selected for incorporation into new international guidelines for photoirritancy testing. As a part of this study, Skin2, a cultured human skin system, was used to evaluate the phototoxic potential of chemicals with known photoirritative properties. The Skin2 ZK1351, a 3-dimensional co-culture system, consists of dermal fibroblasts and a multilayered epidermis comprising differentiated keratinocytes. This product line has previously been used to evaluate the irritative potential of topically applied ingredients and products. In this study, various concentrations of the test chemicals were applied to the epidermal side of the Skin2 tissue for contact times of 1 h or 24 h and then the tissue was exposed to 2.9 J/cm2 of ultraviolet A (UVA) radiation. Treated but nonirradiated tissues were also assayed to predict the cytotoxic potential of the test chemicals, which could mask the phototoxic reaction. After exposure, the tissue substrates were rinsed free of test chemicals and allowed to recover for 24 h. Following this incubation, the MTT reduction assay was used to assess cytotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7947190&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Prospective study of pressure ulcer risk in spinal cord injury patients.

Rodriguez GP, Garber SL.

Physical Medicine and Rehabilitation Department, Baylor College of Medicine, Houston, Texas 77030.

Sixty men with spinal cord injury who had developed pressure ulcers in the past but whose skin was intact when they joined the study were followed for 2 years, or until a pressure ulcer developed. Forty of the men were contacted every 4-6 weeks to answer questions about their skin care practices and to provide a 24 hour urine sample. The others were only contacted at the beginning and the end of the study to answer a questionnaire and to provide a urine sample. Changes in skin collagen metabolism were monitored by measuring urinary excretion of a metabolite, glucosyl-galactosyl hydroxylysine (glu-gal Hyl), corrected for creatinine excretion. Sustained increases in levels of glu-gal Hyl excretion were detected at least 2 months and as much as 5 months in advance of overt clinical signs of ulcer development. Increased excretion of glu-gal Hyl was significantly associated (p < 0.05) with the development of a pressure ulcer. An increase in the urinary excretion of glu-gal Hyl is an indication of increased degradation of skin collagen. Body mass index (weight/height2) of 33% of subjects with pressure ulcers, and 12% of those without, was at least one standard deviation below the mean of all subjects. Thirty-six percent of those who smoked developed ulcers, while only 26% of the nonsmokers did.(ABSTRACT TRUNCATED AT 250 WORDS)

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8008417&dopt=Abstract skin, skin care, skin care medicine skin-care-1.matches: skin care
Skin care intervention for patients having cardiac surgery.

Pokorny ME, Koldjeski D, Swanson M.

School of Nursing, East Carolina University, Greenville, NC, USA.

BACKGROUND: Pressure ulcers are a major problem after cardiovascular surgery, occurring in 9.2% to 38% of patients. OBJECTIVES: To determine the effectiveness of a skin care intervention program in preventing development of ulcers or progression from one stage to another and to determine the extent to which selected risk factors were associated with development and progression of pressure ulcers. METHODS: A simple interrupted time series design was used. The protocol involved interrelated assessment, staging, and type of intervention provided. The Braden Scale was used to determine risk for skin breakdown. RESULTS: Of the 351 patients in the study, 327 (93%) maintained skin integrity and 24 (7%) had skin breakdown. Breakdown by stages was as follows: stage 1, 62% (n = 15); stage 2, 29% (n = 7); stage 3, 4% (n = 1); and stage 4, 4% (n = 1). Age, sex (female), and heart failure were statistically significant risk factors for breakdown (P = < .001, .02, and .02, respectively). The mean scores on the Braden Scale of the breakdown group differed significantly from those of the skin integrity group from days 2 through 5 after surgery (P = .01). Seventeen (71%) of the breakdowns occurred during the first 4 days after surgery. CONCLUSIONS: Skin assessments and nursing interventions should be increased on the day of surgery and the first to fifth postoperative days, including multiple assessments and skin care focused on maintaining skin integrity.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14619359&dopt=Abstract skin, skin care, skin care medicine skin-care-1.matches: skin care
Outpatient pilonidal sinotomy complemented with good wound and surrounding skin care.

Al-Naami MY.

Assistant Professor, Department of Surgery, King Khalid University Hospital, PO Box 7805 (37), Riyadh 11472, Kingdom of Saudi Arabia. Tel. +966 |(1) 46715854679417. Fax. +966 (1) 4679493. E mail: mohammed_alnaami yahoo.com.

OBJECTIVE: To describe an improved method for treating pilonidal sinus disease. METHODS: An outpatient procedure involves laying the pilonidal sinus tract open under local anesthesia, removal of hair and debris, curettage of granulation tissue, with subsequent daily dressing, weekly shaving, and let it heal by secondary intention. The medical records of 100 patients underwent this procedure were studied regarding complications, healing time, and recurrence. This study was carried out at King Abdul-Aziz Medical City, Riyadh, Kingdom of Saudi Arabia, between January 2000 and December 2003. RESULTS: Ninety-five patients (95%) were males and 5 patients (5%) were females. The mean age was 21.7 years. Almost all patients who underwent the procedure were discharged after the procedure. Complications included 2 cases (2%) of bleeding, one case (1%) of vasovagal attack requiring admission overnight, 10 cases (10%) of delayed healing, and 2 cases (2%) of recurrence after an average of one year from complete wound healing. Ninety patients (90%) had completed healing after one month of daily dressing and 10 patients (10%) after 2 months. CONCLUSION: Outpatient pilonidal sinotomy with good wound and surrounding skin care is an ideal approach with high chance of cure.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15770307&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
Patient teaching for an ileoanal reservoir.

Wilson RE.

Creation of an ileoanal reservoir involves a two-stage surgical procedure. Each stage requires extensive patient education. After stage I, the patient must learn to manage an ileostomy, maintain fluid and electrolyte balance, care for perianal skin irritation, implement dietary changes, and reestablish bowel control. Stage II involves reanastomosis of the bowel, and patient education continues with emphasis on bowel reeducation and skin care. Complications can be frequent, but they may be eliminated or at least minimized by educating the patient. Patients having this procedure usually have had a stressful medical history and are highly motivated to return to a normal lifestyle, yet they still need emotional support. Patient education sheets provide a means to summarize the necessary information. Written instructions provide reinforcement for demonstrations and aid in retention of knowledge.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8110885&dopt=Abstract skin, skin care, skin care medicine skin-care-5.matches: skin care
A low-literacy skin care manual for spinal cord injury patients.

Yasenchak PA, Bridle MJ.

Most patient education materials are written at least two grade levels above the average grade achievement of health care consumers. This paper describes the development of a patient education manual for people with low literacy skills. The manual provides information about pressure ulcer prevention for patients with spinal cord injuries. Educational principles related to literacy skills were applied to produce a manual at the fifth-grade reading level.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8134317&dopt=Abstract skin, skin care, skin care medicine