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Neonatal intensive care practices and the influence on skin condition.
MedLine Citation:
PMID:  22340077     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background  Premature skin has a thinner epidermis with a poorly formed stratum corneum (SC) barrier compared to full term skin. Poor skin integrity increases the risk of exposure to irritants and infectious agents. Interventions that facilitate skin maturation are essential. Objective  The objective was to examine the effects of prematurity and time from birth on SC maturation and to identify factors that impact skin condition. Methods  A retrospective review was conducted among 130 NICU patients. Skin regions were evaluated for erythema, rash, integrity and function. The effects of gestational age, time from birth, stool exposure, nutrition and diagnosis were examined. Results  Three groups emerged: (i) premature and <38 weeks adjusted age; (ii) premature and >38 weeks adjusted age; and (iii) full term. Surprisingly, the premature infants exhibited lower perineal irritation and greater SC integrity (lower transepidermal water loss) than full terms (P < 0.05). Group 2 had a longer time before the first skin-stool contact. Chest skin pH showed maturational changes for Group 1 (P < 0.05) but did not change for premature Group 2 who was older at enrollment. Erythema was lower for infants using elemental formulas or total parenteral nutrition. Conclusions  Premature infants with early stool contact and high exposure, full term infants, and patients with congenital diaphragmatic hernia or trisomy 21 are at high risk for skin compromise and may benefit from prophylactic interventions to minimize compromise. Low stool exposure and greater time before the first stool contact appear to be protective against skin compromise.
Authors:
M O Visscher; T Taylor; V Narendran
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-20
Journal Detail:
Title:  Journal of the European Academy of Dermatology and Venereology : JEADV     Volume:  -     ISSN:  1468-3083     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9216037     Medline TA:  J Eur Acad Dermatol Venereol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.
Affiliation:
Skin Sciences Program, Neonatal Intensive Care Unit, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Department of Surgery, and Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
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