| 265 |
Clinical Research
|
Evaluation of maceration by trans epidermal water loss (TEWL) in patients with venous leg ulcers Valentina Dini, Francesca Salibra, Cinzia Brilli, Mariastefania Bertone, Marco Romanelli, Department of Dermatology University of Pisa, Pisa, Italy Objectives:.Maceration is a largely under-estimated problem and one of the causes of delayed wound healing in chronic wounds (1). Exudate management of chronic venous leg ulcers is a critical aspect in wound bed preparation, which focuses on optimizing conditions to promote endogenous healing. Recently the measurment of trans epidermal water loss (TEWL) was introduced as a new objective parameter to monitor the condition of surrounding skin in venous leg ulcers (2). .Materials and methods:.In this study we included 30 patients (16 women and 14 men, mean age 58 years) with chronic venous leg ulcers. All patients were sequential and non selected, and all had clinical and laboratory evidence of venous insufficiency. In addition, arterial insufficiency was excluded in all patients by taking an anckle brachial pressure index measurement > 0.8. We excluded diabetic patients with advanced small vessels disease and ulcers with clinical signs of infection. Patients received standard treatment. Clinical scoring for maceration was done at a medial and lateral surrounding skin site, midway between upper and lower margin of the ulcer by a blinded observer using a severity scoring system. Measurements of TEWL were taken at the same site assessed for clinical observation using a portable device*(3). Measurements were taken weekly for a maximum of four weeks. .Results:.Baseline TEWL on the perilesional skin (median range) was 287 g/hm² and 112 g/hm² at 4 weeks, with a reduction of 40%. Clinical scoring significantly correlated with different levels of TEWL. .Conclusions:.In this study we were able to demonstrate that TEWL is an appropriate parameter to monitor the maceration of perilesional skin. We found TEWL measurement a simple, rapid, valid and reproducible method which can be used daily in clinical practice and in research .*Vapometer - Delfin Technologies Ltd - Finland. Cutting KF. Maceration of the skin and wound bed: its nature and causes. J Wound Care. 2002;11:7 Schultz G, Mozingo D, Romanelli M. Wound healing and TIME: new concepts and scientific applications. Wound Rep Regen. 2005:13:S1ÐS11 De Pepe K, Houben E, Adam R, Wiesemann F. Validation of a VapoMeter, a closed unventilated chamber system to assess trans epidermal water loss vs. the open chamber Tewameter. Skin Res Technol. 2005:11:61Ð69. . |
|