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Stratum corneum integrity as a predictor for peristomal skin problems in ostomates.
Br J Dermatol. 2010 Feb 01; 162(2):357-61.BJ

Abstract

BACKGROUND

Peristomal skin problems are common, most often the result is disruption of the skin barrier and this may account for more than one in three visits to ostomy nurses. Therefore a specific assessment of individual risk factors relating to the skin barrier function would be of great interest.

METHODS

Skin barrier integrity in ostomy patients with peristomal skin problems (PSP) was compared with that of ostomy patients with normal skin (controls) using transepidermal water loss (TEWL). Mechanical barrier disruption was determined by a tape stripping test and chemical barrier disruption [sodium lauryl sulphate (SLS) 0.25%].

RESULTS

Patients and controls had a highly significant increase in TEWL value in the peristomal area compared with nonperistomal contralateral abdominal skin (P < 0.0001 for both groups). The skin barrier of normal-looking contralateral skin of ostomates was found to be borderline impaired in patients with PSP compared with those without. A linear association was seen between the number of tape strips removed and TEWL for both cases and controls. Tape stripping suggested that patients with PSP had less resilient skin (P = 0.002). A significant difference in TEWL value between cases and controls was also seen for the SLS patch test on the dorsal skin (P = 0.02).

CONCLUSION

Successive tape stripping, a situation analogous to the normal use of a pouching system, caused a higher degree of barrier damage more rapidly in patients with PSP, indicating an impaired mechanical quality of the barrier. The SLS exposure test suggested a generally increased susceptibility to irritant dermatitis as assessed by TEWL. Our findings suggest tape stripping and SLS testing may have a role as predictive tests to identify patients at risk of PSP.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Nybaek H
Department of Dermatology, Roskilde Hospital, Koegevej 7-13, Roskilde 4000, Denmark. hany@regionsjaelland.dk
Lophagen S
No affiliation info available
Karlsmark T
No affiliation info available
Bang Knudsen D
No affiliation info available
Jemec GB
No affiliation info available

MeSH

AdultAgedAged, 80 and overCase-Control StudiesFemaleHumansMaleMiddle AgedOstomyPredictive Value of TestsRisk FactorsSeverity of Illness IndexSkinSkin AbsorptionSkin DiseasesSodium Dodecyl SulfateSurface-Active AgentsSurgical TapeWater Loss, Insensible

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19811497

Citation

Nybaek, H, et al. "Stratum Corneum Integrity as a Predictor for Peristomal Skin Problems in Ostomates." The British Journal of Dermatology, vol. 162, no. 2, 2010, pp. 357-61.
Nybaek H, Lophagen S, Karlsmark T, et al. Stratum corneum integrity as a predictor for peristomal skin problems in ostomates. Br J Dermatol. 2010;162(2):357-61.
Nybaek, H., Lophagen, S., Karlsmark, T., Bang Knudsen, D., & Jemec, G. B. (2010). Stratum corneum integrity as a predictor for peristomal skin problems in ostomates. The British Journal of Dermatology, 162(2), 357-61. https://doi.org/10.1111/j.1365-2133.2009.09418.x
Nybaek H, et al. Stratum Corneum Integrity as a Predictor for Peristomal Skin Problems in Ostomates. Br J Dermatol. 2010 Feb 1;162(2):357-61. PubMed PMID: 19811497.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stratum corneum integrity as a predictor for peristomal skin problems in ostomates. AU - Nybaek,H, AU - Lophagen,S, AU - Karlsmark,T, AU - Bang Knudsen,D, AU - Jemec,G B E, Y1 - 2009/07/20/ PY - 2009/10/9/entrez PY - 2009/10/9/pubmed PY - 2010/5/27/medline SP - 357 EP - 61 JF - The British journal of dermatology JO - Br J Dermatol VL - 162 IS - 2 N2 - BACKGROUND: Peristomal skin problems are common, most often the result is disruption of the skin barrier and this may account for more than one in three visits to ostomy nurses. Therefore a specific assessment of individual risk factors relating to the skin barrier function would be of great interest. METHODS: Skin barrier integrity in ostomy patients with peristomal skin problems (PSP) was compared with that of ostomy patients with normal skin (controls) using transepidermal water loss (TEWL). Mechanical barrier disruption was determined by a tape stripping test and chemical barrier disruption [sodium lauryl sulphate (SLS) 0.25%]. RESULTS: Patients and controls had a highly significant increase in TEWL value in the peristomal area compared with nonperistomal contralateral abdominal skin (P < 0.0001 for both groups). The skin barrier of normal-looking contralateral skin of ostomates was found to be borderline impaired in patients with PSP compared with those without. A linear association was seen between the number of tape strips removed and TEWL for both cases and controls. Tape stripping suggested that patients with PSP had less resilient skin (P = 0.002). A significant difference in TEWL value between cases and controls was also seen for the SLS patch test on the dorsal skin (P = 0.02). CONCLUSION: Successive tape stripping, a situation analogous to the normal use of a pouching system, caused a higher degree of barrier damage more rapidly in patients with PSP, indicating an impaired mechanical quality of the barrier. The SLS exposure test suggested a generally increased susceptibility to irritant dermatitis as assessed by TEWL. Our findings suggest tape stripping and SLS testing may have a role as predictive tests to identify patients at risk of PSP. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/19811497/Stratum_corneum_integrity_as_a_predictor_for_peristomal_skin_problems_in_ostomates_ DB - PRIME DP - Unbound Medicine ER -