2005 Symposium on Advanced Wound Care | |
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Laboratory Research
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Introducing an advanced, novel topical preparation for the protection of the perineal region from the damaging effects of two key endogenous digestive enzymes. D.W. Brett, BS, BS, MS, Smith & Nephew, Largo, FL Skin breakdown due to incontinence and especially fecal incontinence is mainly due to the presence of digestive enzymes. Current methods of skin protection are not always effective in incontinent patients. It is felt that approximately 33% to 50% of incontinent patients will experience some form of skin breakdown, even using current standards of care. This study involves a topical skin protectant containing 0.5% allantoin and a digestive enzyme inhibitor (Inhibitor A) to address the clinical need outlined above. This product contains a digestive enzyme inhibitor of serine proteases and lipases. Serine proteases and lipases contribute to the breakdown of skin due to the contact of feces and/or gastric fluids with the skin. The study data indicates that the inhibitors tested were able to decrease the activity of trypsin. INHIBITOR A was somewhat better at inhibiting trypsin activity when formulated into a lotion. The INHIBITOR A lotion proved to be a more effective lipase inhibitor than the INHIBITOR B lotion. References Erwin-Toth P. Peristomal skin care. Lifeline Letter. November/December 1995. http://www.choc.com/dev/pediatric/hhg/gastcare.htm Gray M, Ratliff C, Donovan A. Perineal skin care for the incontinent patient. Adv Skin Wound Care. 2002;15(4):170–175. Hu TW, Igou J, Kaltreider L, et al. Cost-effectiveness evaluation of bladder training. 1984 Lyder CH, Clemes-Lowrance C, Davis A, Sullivan L, Zucker A. Structured skin care regimen to prevent perineal dermatitis in the elderly. J ET Nurs. 1992;19(1):12–16. |
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