skin-care-4.matches: skin care
One year later: did the quality circle of geriatric hip fracture care achieve quality outcomes?

Leininger SM.

Orthopedics and Urology Services, West Penn Allegheny University Hospitals, Pittsburgh, USA.

In 1 year, the Geriatric Orthopaedic Hip Fracture Program saw various positive results. The accomplishments are as follows: Appropriate use of consulting services. Reduction in the mortality rate. Increase in the number of patients (76%) who returned to home versus skilled nursing facilities. Reduction of LOS. Fifty-seven percent of patients are independent with ADLs at 6 months after hip fracture repair. Sixty-four percent remain independent ambulators and use aids on an as needed basis. Our team has learned that we need to improve certain areas of the program. We need to reinforce to the staff the importance of following skin care and toileting guidelines. Other research articles looking at the overall condition of the geriatric patient have used the Apache score or the Anesthesia Rating score and we plan to follow suit. The Apache and Anesthesia ratings have been used to predict outcomes; the higher the score, the less successful the outcome. Within the cost structure, we needed to become more aware of the comorbidity costs and identify opportunities to address these issues.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10855150&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
A nursing protocol for the management of perineal-rectal skin alterations.

Haisfield-Wolfe ME, Rund C.

Perineal-rectal care is defined as skin care to the region between the vulva and anus in the female and scrotum and anus in the male (Costello, 1997). Perineal-rectal care is essential to prevent infection and promote comfort but is complicated by the anatomical location of the perineum and rectum. In addition, no standardized perineal-rectal care approach exists. Patients with cancer are at particular risk for developing perineal-rectal skin breakdown because of immunosuppression, side effects of radiation and chemotherapy, and compromised nutritional status. A perineal-rectal skin-care protocol is presented that incorporates recommendations for routine care as well as recommendations for managing common skin alterations, including erythema, dry and moist desquamation, and infection.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10865579&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Skin barrier properties in different body areas in neonates.

Yosipovitch G, Maayan-Metzger A, Merlob P, Sirota L.

Department of Dermatology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, Israel.

OBJECTIVE: The aim of the study was to investigate skin barrier function in neonates in different anatomic sites during the first 2 days of life. DESIGN: The study population consisted of 44 healthy full-term newborn infants. Transepidermal water loss (TEWL), stratum corneum hydration (SCH), and skin surface pH were measured in different anatomic sites (forehead, flexor part of forearm, upper back, abdomen, inguinal region, palms, and soles) during the first 10 hours of life and 24 hours later. Measurements were recorded with a Tevameter, a Corneometer, and a skin pH meter with a flat glass electrode. Results were compared with those in 20 healthy adults. RESULTS: TEWL was lower in infants than in adults in the forehead, palms, soles, and higher in the forearms. It was significantly higher on day 1 than on day 2 in the soles, palms, and forearms, and in the forearm, palms, and inguinal region compared with the other anatomic sites. SCH was significantly lower in the infants on the forehead, back, and abdomen, and higher on the forearms and palms; it was significantly higher on the first day of life on the forearms and palms, and lower in the inguinal region. Skin surface pH was significantly higher in the infants in all body sites (>6.6 in most measurements). On day 2, it was significantly lower than on day 1, but still higher than in adults. SCH correlated positively with TEWL in the neonates but not in the adults. None of the variables were related to gestational age, sex, mode of delivery, or body weight. CONCLUSIONS: Changes take place in SCH, water loss, and pH in the first 2 days after birth, suggesting that the stratum corneum barrier is still in the process of adapting to extrauterine life. The significant anatomic variability in TEWL and SCH should be taken into account in evaluating the permeation of skin care products and topical medications in newborns.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10878157&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
An overview of aesthetic surgery of the face.

Guthrie PB.

This article explores the interface between the aesthetic aspects of dentistry and complementary cosmetic surgery of the face. Dentists do not often think of facial cosmetic surgery and plastic surgeons do not often think of aesthetic dentistry as being complementary to their endeavours. This paper is designed to help breach this gap. An outline is given of the various cosmetic surgery procedures used on the face with emphasis on those in the perioral region. Procedures discussed include meloplasty, blepharoplasty, laser resurfacing, liposculpture, lip augmentation, rhinoplasty, chin augmentation, correction of prominent ears, and skin care.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10895625&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Postoperative small bowel fistula: back to basics.

Bissett IP.

Department of Surgery, Western Regional Hospital, Pokhara, Nepal. i.bissett auckland.ac.nz

Twenty-one patients presenting between January 1992 and January 1998 with postoperative small bowel fistula were reviewed and their management and outcome were recorded. There were six jejunal and 15 ileal fistulae. Seven fistulae were low output and 14 high output. The management principles included: (i) initial resuscitation and skin care; (ii) early surgery for sepsis, or for a high-output fistula which showed no signs of decrease by 10 days, or total wound breakdown. Surgery involved, where possible, fistula resection with double enterostomy, a feeding gastrostomy and abdominal drainage; and (iii) enteral feeding with refeeding of enterostomy output into the distal stoma if required to correct fluid and electrolyte imbalance and malnutrition. Five patients died and in the other 16 their fistulae closed and they are alive and well.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10902468&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Gemini Surfactants.

Menger FM, Keiper JS.

Department of Chemistry Emory University Atlanta, GA 30322 (USA).

How easy it is to dismiss the humdrum surfactant! After all, its structure is unglamorous by present-day norms. And the surfactant has been entrenched in so many areas of commerce for so many decades that its chemistry might seem old and tired. The purpose of this review is to persuade the reader otherwise, all the while focusing on a remarkable new surfactant, the gemini. Geminis, the common name for "bis-surfactants", can self-assemble at concentrations almost a hundredfold lower than for corresponding conventional surfactants. Surface activity can be improved a thousandfold. Geminis have already shown promise in skin care, antibacterial regimens, construction of high-porosity materials, analytical separations, and solubilization processes. Scores of patents dealing with geminis have appeared in the last few years. Indeed, geminis might well turn out, in the opinion of some, to be more useful to "l'homme de la rue" than crown ethers or fullerenes. This review delves into such topics as synthesis, critical micellization concentration, aggregate size and shape, gels, vesicles, and films. The information comes from scientists all over the world; one might say that gemini research is bathed in a continuous sunlight or summer. No prior knowledge of colloid chemistry is presupposed in this article.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10940980&dopt=Abstract skin, skin care, skin care medicine skin-care-4.matches: skin care
Skin irritation from air-oxidized ethoxylated surfactants.

Bodin A, Fischer T, Bergh M, Nilsson JL, Karlberg AT.

Occupational Dermatology, National Institute for Working Life, Stockholm, Sweden.

Surfactants are known to be skin irritants, but change in their irritant potential due to change in composition during handling and storage has not previously been investigated. The aim of this study was to investigate the influence of oxidation products on the irritant potential of a non-ionic ethoxylated alcohol, C12E5. Pure and oxidized C12E5 were tested, using 2 different patch test procedures; 1 with a single 24 h exposure and 1 with repeated exposures. 18 healthy volunteers participated in each of these studies. Evaluations were made by visual scoring and by measurement of transepidermal water loss and skin blood flow. In the single exposure study, no significant difference in skin irritation was observed between pure C12E5 and a sample of oxidized C12E5 at the concentrations tested (1, 3, 9 and 27%). After repeated exposures, however, the oxidized C12E5 was significantly more irritant than pure C12E5 at the concentrations 9% and 27% (p<0.05). Non-ionic ethoxylated surfactants are known for their weak skin irritant effect and are, due to this, often included in products with prolonged contact with the skin, i.e., skin care products. An increased irritant potential after oxidation might be of importance due to the conditions of use.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10945746&dopt=Abstract skin, skin care, skin care medicine