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Marco Romanelli - One of the best experts on this subject based on the ideXlab platform.

  • quantitative evaluation of Maceration in venous leg ulcers by transepidermal water loss tewl measurement
    The International Journal of Lower Extremity Wounds, 2014
    Co-Authors: Valentina Dini, Sabrina Barbanera, Marco Romanelli
    Abstract:

    Skin Maceration is a clinical manifestation in venous leg ulcers that leads to severe consequences for patients’ quality of life and wound management. The aim of this study was to explore the use of transepidermal water loss (TEWL) measurement technique to quantify different level of surrounding Skin Maceration in patients with venous leg ulcers. A total of 50 patients were recruited and TEWL measurements were taken with a portable device on different locations surrounding the leg ulcer and on control Skin. A clinical score for Maceration was used and correlated to the involvement of surrounding Skin. Statistically significant differences of TEWL values were noted between affected Skin and control site (P < .001). Statistics showed an increase in TEWL values as the Maceration clinical score increased (r = 0.954). Objective monitoring of Skin Maceration in venous leg ulcer with TEWL measurement represents an useful tool to analyze morphologic changes at different time points during treatment.

  • quantitative evaluation of Maceration in venous leg ulcers by transepidermal water loss tewl measurement
    The International Journal of Lower Extremity Wounds, 2014
    Co-Authors: Valentina Dini, Sabrina Barbanera, Marco Romanelli
    Abstract:

    Skin Maceration is a clinical manifestation in venous leg ulcers that leads to severe consequences for patients’ quality of life and wound management. The aim of this study was to explore the use of transepidermal water loss (TEWL) measurement technique to quantify different level of surrounding Skin Maceration in patients with venous leg ulcers. A total of 50 patients were recruited and TEWL measurements were taken with a portable device on different locations surrounding the leg ulcer and on control Skin. A clinical score for Maceration was used and correlated to the involvement of surrounding Skin. Statistically significant differences of TEWL values were noted between affected Skin and control site (P < .001). Statistics showed an increase in TEWL values as the Maceration clinical score increased (r = 0.954). Objective monitoring of Skin Maceration in venous leg ulcer with TEWL measurement represents an useful tool to analyze morphologic changes at different time points during treatment.

  • A study to compare a new self-adherent soft silicone dressing with a self-adherent polymer dressing in stage II pressure ulcers.
    Ostomy Wound Management, 2003
    Co-Authors: Maume S, Marco Romanelli, Van De Looverbosch D, Heyman H, Ciangherotti A, Charpin S
    Abstract:

    Pressure ulcers are common among elderly nursing home residents. To be effective in managing these wounds, a dressing should maintain a moist environment, facilitate healing, absorb exudate, remain in place for a number of days, and prevent trauma to the surrounding Skin. An 8-week, open, randomized, multicenter, controlled study was conducted to compare the effects of a new self-adherent soft silicone dressing and a self-adherent hydropolymer dressing on Stage II pressure ulcers. Thirty-eight (38) residents participated in the study. Eighteen residents (mean age 83. 8 years, range 74.9 to 95.1 years) were randomized to wound management with a soft silicone dressing, and the ulcers of 20 residents (mean age 82.5 years, range 66.4 to 91.9 years) were managed with a hydropolymer dressing. Wound healing wound and surrounding Skin characteristics, and ease of dressing removal were measured and documented. During the study, eight (44%) ulcers in the soft silicone group and 10 (50%) in the hydropolymer dressing group healed. Both dressings were changed approximately once a week and no differences in signs of inflammation, amount of exudate and odor, or incidence of leakage were observed. Damage to the surrounding Skin, Maceration, and dressing removal difficulties were less common with the soft silicone dressing. Differences in tissue damage between the two dressings were significant during weeks 1, 2, and 3 (P < 0.05). Studies with a larger sample size are needed to confirm these findings.

Valentina Dini - One of the best experts on this subject based on the ideXlab platform.

  • quantitative evaluation of Maceration in venous leg ulcers by transepidermal water loss tewl measurement
    The International Journal of Lower Extremity Wounds, 2014
    Co-Authors: Valentina Dini, Sabrina Barbanera, Marco Romanelli
    Abstract:

    Skin Maceration is a clinical manifestation in venous leg ulcers that leads to severe consequences for patients’ quality of life and wound management. The aim of this study was to explore the use of transepidermal water loss (TEWL) measurement technique to quantify different level of surrounding Skin Maceration in patients with venous leg ulcers. A total of 50 patients were recruited and TEWL measurements were taken with a portable device on different locations surrounding the leg ulcer and on control Skin. A clinical score for Maceration was used and correlated to the involvement of surrounding Skin. Statistically significant differences of TEWL values were noted between affected Skin and control site (P < .001). Statistics showed an increase in TEWL values as the Maceration clinical score increased (r = 0.954). Objective monitoring of Skin Maceration in venous leg ulcer with TEWL measurement represents an useful tool to analyze morphologic changes at different time points during treatment.

  • quantitative evaluation of Maceration in venous leg ulcers by transepidermal water loss tewl measurement
    The International Journal of Lower Extremity Wounds, 2014
    Co-Authors: Valentina Dini, Sabrina Barbanera, Marco Romanelli
    Abstract:

    Skin Maceration is a clinical manifestation in venous leg ulcers that leads to severe consequences for patients’ quality of life and wound management. The aim of this study was to explore the use of transepidermal water loss (TEWL) measurement technique to quantify different level of surrounding Skin Maceration in patients with venous leg ulcers. A total of 50 patients were recruited and TEWL measurements were taken with a portable device on different locations surrounding the leg ulcer and on control Skin. A clinical score for Maceration was used and correlated to the involvement of surrounding Skin. Statistically significant differences of TEWL values were noted between affected Skin and control site (P < .001). Statistics showed an increase in TEWL values as the Maceration clinical score increased (r = 0.954). Objective monitoring of Skin Maceration in venous leg ulcer with TEWL measurement represents an useful tool to analyze morphologic changes at different time points during treatment.

Koray Karabulut - One of the best experts on this subject based on the ideXlab platform.

  • modified limberg transposition flap in the treatment of pilonidal sinus disease
    Techniques in Coloproctology, 2012
    Co-Authors: B. Kaya, Cengiz Eris, Suleyman Atalay, Nuriye Esen Bulut, B Mantoglu, Koray Karabulut
    Abstract:

    Background Pilonidal sinus disease (PSD) is a common problem in surgical practice. Different non-surgical and surgical methods have been used for treating PSD. Flap techniques including the Limberg flap have become more popular in recent years. A modified Limberg flap was used to reduce the problems of Skin Maceration and recurrence associated with the conventional Limberg flap technique. The aim of this retrospective study was to assess the effectiveness of the modified Limberg flap technique for PSD.

  • Modified Limberg transposition flap in the treatment of pilonidal sinus disease
    Techniques in Coloproctology, 2012
    Co-Authors: B. Kaya, Cengiz Eris, Suleyman Atalay, Nuriye Esen Bulut, B Mantoglu, O. Bat, Koray Karabulut
    Abstract:

    Background Pilonidal sinus disease (PSD) is a common problem in surgical practice. Different non-surgical and surgical methods have been used for treating PSD. Flap techniques including the Limberg flap have become more popular in recent years. A modified Limberg flap was used to reduce the problems of Skin Maceration and recurrence associated with the conventional Limberg flap technique. The aim of this retrospective study was to assess the effectiveness of the modified Limberg flap technique for PSD. Methods Medical records of 94 patients with PSD who had been treated with a modified Limberg flap between December 2006 and 2009 were evaluated. The patients’ age, sex, duration of preoperative symptoms, operative time, mean hospital stay, postoperative complications, wound infection rate, Maceration rate and recurrence rate, time until return to work, time until sitting on the toilet without pain, hypoesthesia in the gluteal region, and satisfaction score were recorded during follow-up or at the last interview. Clinical data were obtained at the end of the 5th postoperative day and at 1, 3, 6, and 12 months following surgery. Results There were 83 male and 11 female patients. The mean operative time was 38.95 ± 6.77 min (range 30–67 min). All patients were followed up longer than 12 months, and the mean follow-up period was 30.97 ± 12.7 months (range 12–54 months). While wound dehiscence was observed in only one patient, we did not detect any case of flap necrosis. Two cases of seroma were observed. Wound infection was detected in 5 patients (5.3%). Surgical drainage was performed in 2 cases. Another 3 patients were treated with oral antibiotics. Maceration of the surgical incision site was detected in 8 patients (8.5%) who were all successfully treated with conservative measures. There were 4 patients (4.2%) with recurrence in this series. Conclusions When compared with the available data on use of the conventional Limberg flap for PSD, our results suggest that use of the modified Limberg flap is associated with a lower Maceration and recurrence rate, and greater patient satisfaction.

M S Perezcoello - One of the best experts on this subject based on the ideXlab platform.

  • combined effects of prefermentative Skin Maceration and oxygen addition of must on color related phenolics volatile composition and sensory characteristics of airen white wine
    Journal of Agricultural and Food Chemistry, 2011
    Co-Authors: Maria Jesus Cejudobastante, L Castrovazquez, Isidro Hermosingutierrez, M S Perezcoello
    Abstract:

    The effects of the joint prefermentative Maceration and hyperoxygenation of Airen white must and wine on the phenolic content, chromatic characteristics, volatile composition, and sensory characteristics, not previously described in combination, have been evaluated. A total of 20 phenolic and 149 volatile compounds have been identified and quantified for that purpose. As a consequence of the oxygen addition, the concentrations of hydroxycinnamic acid derivatives and flavan-3-ols decreased (above all t-GRP and (+)-catechin), leading to color stabilization, but also the concentrations of several volatile compounds with a great importance for quality aroma decreased. Prefermentative Skin Maceration, previously applied to the hyperoxygenation of Airen musts, provided the aforementioned color stabilization in the respective wine but also increased the content of short-chain fatty acid esters and terpenes and decreased the concentration of C6 alcohols. That combination of prefermentative treatments (Skin macera...

Takeo Minematsu - One of the best experts on this subject based on the ideXlab platform.

  • Influence of digestive enzymes on development of incontinence-associated dermatitis: Inner tissue damage and Skin barrier impairment caused by lipidolytic enzymes and proteases in rat macerated Skin.
    International Wound Journal, 2018
    Co-Authors: Yuko Mugita, Takeo Minematsu, Gojiro Nakagami, Hiromi Sanada
    Abstract:

    One of the most common complications in patients with incontinence is incontinence-associated dermatitis. This study aimed to examine the influences of lipidolytic enzymes and/or proteases on Skin barrier and tissue structure on the development of incontinence-associated dermatitis. Two animal experiments, ex vivo and in vivo, were performed using rats to examine the influences of 3 factors (Maceration, proteases, and lipidolytic enzymes) alone or in various combinations on the barrier function and histology of the Skin. As a result, Skin treatments, including both of the Skin Maceration and proteases application, caused erythrocyte leakage from the blood vessels in the dermis. The erythrocyte leakage was observed in a larger area in the Skin treated with proteases and lipidolytic enzymes with Maceration than in the Skin treated with proteases with Maceration, that is, the addition of lipidolytic enzymes to Skin Maceration with proteases enhanced erythrocyte leakage. Lipidolytic enzymes in macerated Skin are factors that accelerate tissue damage via Skin barrier impairment, and proteases are the factors that trigger the development of incontinence-associated dermatitis via tissue damage. Advanced nursing care of perineal Skin in patients with faecal incontinence is required because of the deleterious influence of lipidolytic enzymes and proteases.

  • Histopathology of Incontinence-Associated Skin Lesions: Inner Tissue Damage Due to Invasion of Proteolytic Enzymes and Bacteria in Macerated Rat Skin.
    PLOS ONE, 2015
    Co-Authors: Yuko Mugita, Takeo Minematsu, Takashi Nagase, Lijuan Huang, Gojiro Nakagami, Chihiro Kishi, Yoshie Ichikawa, Hiroshi Noguchi, Taketoshi Mori
    Abstract:

    A common complication in patients with incontinence is perineal Skin lesions, which are recognized as a form of dermatitis. In these patients, perineal Skin is exposed to digestive enzymes and intestinal bacterial flora, as well as excessive water. The relative contributions of digestive enzymes and intestinal bacterial flora to Skin lesion formation have not been fully shown. This study was conducted to reveal the process of histopathological changes caused by proteases and bacterial inoculation in Skin Maceration. For Skin Maceration, agarose gel containing proteases was applied to the dorsal Skin of male Sprague-Dawley rats for 4 h, followed by Pseudomonas aeruginosa inoculation for 30 min. Macroscopic changes, histological changes, bacterial distribution, inflammatory response, and keratinocyte proliferation and differentiation were examined. Proteases induced digestion in the prickle cell layer of the epidermis, and slight bleeding in the papillary dermis and around hair follicles in the macerated Skin without macroscopic evidence of erosion. Bacterial inoculation of the Skin macerated by proteolytic solution resulted in the formation of bacteria-rich clusters comprising numerous microorganisms and inflammatory cells within the papillary dermis, with remarkable tissue damage around the clusters. Tissue damage expanded by day 2. On day 3, the proliferative keratinocyte layer was elongated from the bulge region of the hair follicles. Application of proteases and P. aeruginosa induced Skin lesion formation internally without macroscopic erosion of the overhydrated area, suggesting that the histopathology might be different from regular dermatitis. The healing process of this lesion is similar to transepidermal elimination.

  • Physiological and appearance characteristics of Skin Maceration in elderly women with incontinence
    Journal of Wound Care, 2014
    Co-Authors: Yoshie Ichikawa-shigeta, Takeo Minematsu, Saldy Yusuf, Junko Sugama, Gojiro Nakagami, Chizuko Konya, Hiromi Sanada, Toshio Nakatani, Supriadi, Yuko Mugita
    Abstract:

    Objective: To identify the physiological and appearance characteristics of Skin Maceration caused by urine and/or faeces and determine their suitability as risk indicators for incontinence-associated dermatitis. Method: This cross-sectional, comparative study involved sixty-nine elderly women with urinary and/or faecal incontinence who provided informed consent to participate. Exclusion criteria included serious medical problems, acute illness and the presence of damaged Skin on the buttocks. The physiological and appearance characteristics of macerated Skin on the buttocks of the patients were examined. Stratum corneum and dermis hydration levels, transepidermal water loss and Skin pH were used to assess Skin condition. Skin morphology (sulcus cutis) was confirmed using images at x15 magnification. The erythema index and white index were used to evaluate colour in the macerated Skin areas. Results: Forty-four patients exhibited Skin Maceration. Stratum corneum and dermis hydration levels were significant...

  • physiological and appearance characteristics of Skin Maceration in elderly women with incontinence
    Journal of Wound Care, 2014
    Co-Authors: Yoshie Ichikawashigeta, Takeo Minematsu, Saldy Yusuf, Junko Sugama, Gojiro Nakagami, Chizuko Konya, Hiromi Sanada, Toshio Nakatani, Yuko Mugita
    Abstract:

    OBJECTIVE: To identify the physiological and appearance characteristics of Skin Maceration caused by urine and/or faeces and determine their suitability as risk indicators for incontinence-associated dermatitis. METHOD: This cross-sectional, comparative study involved sixty-nine elderly women with urinary and/or faecal incontinence who provided informed consent to participate. Exclusion criteria included serious medical problems, acute illness and the presence of damaged Skin on the buttocks. The physiological and appearance characteristics of macerated Skin on the buttocks of the patients were examined. Stratum corneum and dermis hydration levels, transepidermal water loss and Skin pH were used to assess Skin condition. Skin morphology (sulcus cutis) was confirmed using images at x15 magnification. The erythema index and white index were used to evaluate colour in the macerated Skin areas. RESULTS: Forty-four patients exhibited Skin Maceration. Stratum corneum and dermis hydration levels were significantly greater in the Maceration group than in the non-Maceration group, as were transepidermal water loss, Skin pH and differences in sulcus cutis interval between the buttock of interest and the subumbilical region. Furthermore, differences in the erythema and white indices between these two regions were significantly higher and lower, respectively, in the Maceration group than in the non-Maceration group. CONCLUSION: To our knowledge, this is the first report to note that there are interesting changes not only in the epidermal layer but also in the dermis layer in patients with Skin Maceration. This finding confirmed that Skin Maceration caused by incontinence is a severe condition. Moreover, the erythema index was the best index for identifying Skin Maceration caused by incontinence, indicating that it can be used for precise and easy identification of the condition in clinical practice.

  • aging enhances Maceration induced ultrastructural alteration of the epidermis and impairment of Skin barrier function
    Journal of Dermatological Science, 2011
    Co-Authors: Takeo Minematsu, Takashi Nagase, K Takehara, Kazunori Komagata, Lijuan Huang, Shinji Iizaka, Gojiro Nakagami, Ayumi Naito, Yuko Yamamoto, Tomoko Akase
    Abstract:

    Abstract Background Skin Maceration is recognized as a risk factor for the development of certain Skin lesions. In health care settings, incontinence-associated Skin Maceration is highly prevalent in the elderly. However, the effect of senescence on Maceration has not been fully elucidated. Objective To reveal the enhancement of the Maceration-induced ultrastructural alteration and barrier function of the epidermis by aging. Methods Skin Maceration was reproduced by exposure to agarose gel in human and rat. The ultrastructural alterations in human and rat tissue were observed by transmission electron microscopy. The Skin barrier function was evaluated by noninvasive methods in human, and by the transdermal penetration of small- and large-fluorescent molecules in rat. In order to reveal the effect of aging on the Skin Maceration, we compared these parameters between young and aged rats. Results In macerated Skin, we observed expansion of the interstices of the stratum corneum, spinosum, and basale of the epidermis; disruption of the intercellular lipid structure in the stratum corneum; a decreased number of cell processes in the stratum spinosum and basale. The transdermal penetration test in the rat using two types of fluorescein indicated that Maceration disrupted Skin barrier function. Furthermore, senescence-enhanced ultrastructural and functional alterations were revealed in the rodent studies. Conclusion This study demonstrates that aging enhances Skin Maceration. Considering that Maceration is a risk factor for the Skin damage, the development of technology to promote Skin barrier recovery after Maceration in the elderly is warranted.