Instrumental Evaluation of the Protective Effects of a Barrier Film on Surrounding Skin in Chronic Wounds
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Abstract: Objective. This study investigated the effects of Cavilon® No Sting Barrier Film ([NSBF], 3M Healthcare, St. Paul, Minn) on skin surrounding chronic wounds by means of monitoring transepidermal water loss (TEWL). Methods. Forty patients were examined; 20 patients had pressure ulcers and the other 20 patients had venous leg ulcers. The patients were divided into 2 groups, the first group (treatment group) was treated with NSBF and the second group (control group) was treated with zinc oxide ointment applied to surrounding skin. TEWL values on surrounding skin were monitored before and after the therapy. Results. Statistical evaluation showed an overall reduction of 45% in TEWL values in both groups by the conclusion of the study period when compared to baseline values (P < 0.01). The NSBF application was a quick and simple process. Removal of residue was not necessary. An additional benefit is that the skin can be seen through the film. Conclusion. The study objectively demonstrated that the NSBF can help in the management of the skin surrounding chronic wounds.
The concept of moist wound healing is widely applied in the treatment of chronic wounds. The benefits of a moist healing environment seem to result from epidermal migration, alterations in pH and oxygen levels, the maintenance of an electrical gradient, and the retention of wound fluid. The level of wound moisture is related to several factors. These factors include wound type, phase of wound healing, and absorptive capacity of local dressings.1
A high level of exudate is a commonality among patients with chronic ulcers, often resulting in surrounding skin maceration, subsequent damage to the exposed tissue, and enlargement of the wound.2 Use of protective products can prevent skin damage. Zinc oxide ointment is often used to protect the surrounding skin, but is difficult to remove because a white layer remains on the skin, causing problems in the assessment of wound edges. The aim of the present randomized control trial was to investigate the effects of 2 different types of protective products on the barrier integrity of skin surrounding chronic wounds using an instrumental device to assess transepidermal water loss (TEWL).
TEWL is one of the most important biophysical parameters for evaluating the efficiency of the water barrier in human skin.3 Patients and Methods Forty patients (27 women, 13 men), age range 56–86 years (mean 69 ± 4) who were attending the wound clinic for treatment of chronic venous leg ulcers and pressure ulcers were examined prospectively.
Venous leg ulcers. Twenty patients with venous leg ulcers were included. The mean wound duration was 16 months and the median wound size was 47.5 cm2. All patients were sequential and nonselected. All had clinical and laboratory evidence of venous insufficiency as defined by the following criteria: presence of varicosities, skin hyperpigmentation, irregularly shaped ulcerations on the medial aspect of the leg, and venous reflux confirmed by Doppler flow studies. In addition, patients with arterial insufficiency were excluded who had an Ankle Brachial Pressure Index (ABPI) measurement > 0.8. Patients with diabetes, advanced small vessel disease, and ulcers with clinical signs of infection were excluded. Patients received standard treatment including short stretch compression bandaging and moist wound healing treatment. Pressure ulcers. Twenty patients with pressure ulcers (Grade II–IV) were included. The mean wound duration was 8 months and the median wound size was 5.7 cm2.
Clinical signs of infection served as exclusion criteria. Patients received standard treatment, including pressure redistribution and moist wound healing treatment.
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