Helping Prevent Pressure Ulcers

Pressure UlcerAccording to the National Pressure Ulcer Advisory Panel (NPUAP), a pressure ulcer is “localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear and/or friction”.

Pressure ulcers (also known as bed sores or pressure sores) are a serious issue affecting the quality of life for many individuals with various health complications in different settings including living at home.

Pressure ulcers are a complex healthcare problem with multiple causes.  They are not a new phenomenon since their occurrence was recorded beginning in 2050 BC.  In addition, the early physician, Hippocrates, documented pressure ulcers in 400 BC.  Today, pressure ulcers are a substantial clinical, economic, regulatory and legal problem for healthcare providers and patients.  In fact, it has been estimated that treating pressure ulcers cost the U.S. at least 11 billion dollars per year.

For high-risk populations including critically ill patients, a cumulative incidence of at least 15% has been reported for category 2 or higher pressure ulcers.  There are also many factors that increase the risk for pressure ulcers including advanced age, malnutrition, immobility, loss of consciousness or cognitive abilities, inability to feel pain, decreased blood flow due to diabetes or peripheral arterial disease, as well as dry skin and skin maceration that makes skin more vulnerable to damage.

Increasing Hydration and Protecting Macerated Skin

Senior woman in wheel chairViniferamine® Renewal Moisturizer and Viniferamine® SkinMineralZ contain important skin nutrients including antioxidants, amino acids and vitamins to strengthen vulnerable skin. Renewal Moisturizer increases skin hydration to help keep moisture in skin, as well as ensure proper nourishment of the epidermis.  Each ingredient in Renewal Moisturizer has been perfectly pH balanced.  SkinMineralZ helps nourish macerated, inflamed skin while providing absorption of toxins.  The micronized zinc oxide in SkinMineralZ is ideal for treating delicate skin that cannot tolerate abrasiveness.

Pressure is the amount of force applied perpendicular to a surface area.  In addition, forces known as shear forces may be applied parallel to a skin surface.  Shear forces are commonly applied when patients slide down a surface and they typically affects the sacrum and heel areas of skin.  When pressure is applied to skin, especially over bony prominences, it distorts the skin and underlying soft tissues.  If constant pressure is maintained, soft tissue will change and mold itself to accommodate the external shape, referred to as tissue creep.  Blood vessels within the distorted tissue become compressed, bent or stretched out of their normal shape such that blood cannot flow which results in the tissues supplied by these vessels becoming ischemic.

Changing Positions and Strengthening the Skin Barrier

Normally, reflexive movements relieve tissue distortions, or the central nervous system is stimulated producing pain that causes movement to relieve pressure and distortion before serious damage occurs.  In fact, healthy individuals (that have normal sensation) change positions in their sleep every 11.6 minutes on average.

Young man asleepWhen the circulation is restored, local capillaries dilate and blood flow increases resulting in reactive hyperemia.  This appears as a bright pink blanchable (capable of whitening) patch on the skin.  When the erythema (redness) is unblanchable, that indicates tissue damage characteristic of category 1 pressure ulcers has occurred.

Therefore, there are 3 main causes of pressure ulcers: immobility, failure of reactive hyperemia and loss of sensation.  Pain is an early warning sign for pressure damage and the use of strong pain medicines may delay triggers for movement.  Distortion of soft tissues is particularly dangerous for paraplegic patients.  If ischemia persists, pressure ulcers can occur within 2 hours.  Patients who experience sudden drops in blood pressure due to events such as cardiac arrest may also be at risk for pressure ulcers.  Prolonged pressure can result in skin atrophy and thinning of the protective skin barrier.

Viniferamine® skincare products include ingredients that strengthen skin and improve the skin barrier. Quantitating transepidermal water loss (TEWL) is a way to assess the quality of the skin barrier and how well it functions.  Oleuropein has been shown to reduce TEWL indicating its ability to increase skin barrier function.  Evidence also demonstrates that melatonin has a stimulatory role in building and maintaining the epidermal barrier.

Besides implementing optimal skin care provided by Viniferamine® skin and wound care products, there are other steps that can be taken to reduce the risk of pressure ulcers.  It’s important to reposition patients that are immobilized.  Pressure redistribution support surfaces are also useful.  Patients that cannot move need to be advised to report pain to someone who can help them reposition.  It’s important to be aware of the fact that a source of pain in another location may distract an individual from the pain associated with pressure, reducing the likelihood that the individual will respond to the pain trigger.

It’s good to know that Viniferamine® skincare products include ingredients to decrease inflammation, nourish and strengthen skin, and protect and hydrate skin.  SkinMineralZ helps protect macerated skin to decrease the risk of pressure ulcers and Renewal Moisturizer helps eliminate dry skin, which also decreases the risk of pressure ulcers.

References
1. Dermatol Nurs 2007; 19: 343-349.
2. Am J Critic Care 2008; 17: 328-337.
3. Nursing Times 2002; 98: 41.
4. JAMA 2006: 296: 974-984.
5. Int J Nursing Studies 2015; 52: 1655-1658.
6. Nursing Times 2012: 108: 16-20.
7. Int J Cosmet Sci 2008; 30: 113-120.
8. FASEB J 2013; 27: 2742-2755.

Disclaimer: These statements have not been reviewed by the FDA. The decision to use these products should be discussed with a trusted healthcare provider. The authors and the publisher of this work have made every effort to use sources believed to be reliable to provide information that is accurate and compatible with the standards generally accepted at the time of publication. The authors and the publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or reliance on, the information contained in this article. The publisher has no responsibility for the persistence or accuracy of URLs for external or third party Internet websites referred to in this publication and does not guarantee that any content on such websites is, or will remain, accurate or appropriate.

About the author: Nancy Ray, PhD is the Science Officer at McCord Research. Dr. Ray received her PhD in Biochemistry and Biophysics and was a postdoctoral fellow at NIH, Harvard University and Dana-Farber Cancer Institute, and the University of Iowa. She also earned bachelor of science degrees in Chemistry and Microbiology.

Copyright 2015 McCord Holdings – All Rights Reserved.

Reducing Moisture-Associated Skin Damage

Intertrigo-400x300 Moisture-associated skin damage (MASD) involves skin inflammation, irritation and erosion that results from prolonged exposure to moisture from various sources including urine, stool, wound exudate, perspiration, mucus or saliva.

The four main types of MASD are:

  1. Incontinence-associated dermatitis (IAD)
  2. Intertrigo (in skin folds)
  3. Periwound (around a wound) MASD
  4. Peristomal (around a stoma) MASD

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Protecting Peristomal Skin

Ostomy+ body illustrationMore than 1 million Americans have a stoma, and it has been estimated by the United Ostomy Association of America that 130,000 ostomy surgeries are performed every year in the United States.  Unfortunately, up to 80% of people with a stoma experience peristomal skin problems. Prevention, early identification and proper care for peristomal skin complications are critical for individuals with a stoma.

Stomas can be either temporary or permanent.  A stoma is formed during a surgical procedure (ostomy) to divert the flow of urine or feces outside the body for collection in a stoma appliance or ostomy pouch system that consists of a baseplate, washer with flanges and a pouch for collecting effluent.  There are 3 main types of stoma: the colostomy, the ileostomy and the urostomy.  The reasons for ostomies include cancer involving the colon rectum or bladder, inflammatory bowel diseases such as Crohn’s disease, congenital malformations and diverticular disease.

Several studies suggest that stoma complications within the first 2 to 3 weeks following surgery are common.  85% of individuals with a stoma experience stoma leakage.  A pouch system that fits well immediately following surgery may not fit well several weeks later.  Selection of ostomy equipment that is appropriate for the type of stoma, volume and consistency of the effluent as well as self-care skill level of the individual with a stoma is critical.  Proper use of the stoma appliance including proper pouch application, timely emptying and pouch changing all contribute to helping prevent skin problems. Continue reading

 Avoiding Hand Dermatitis

Hand dermatitis is one of the most common problems encountered in dermatology with a prevalence possibly as high as 50% hand dermatitisor greater in certain occupations. The dis­comfort associated with hand der­matitis frequently results in a de­creased quality of life. In fact, hand dermatitis can be debilitating for many years.

Dermatitis (or eczema) is inflam­mation of the skin, characterized by itchy (pruritic), red, weeping skin with vesicles and/or crusty patches. The risk factors for hand dermatitis include chemical expo­sures, frequent handwashing, and wet-work environments contribut­ing to a higher prevalence in specif­ic occupations including healthcare professionals, machinists, hair­dressers, and food industry em­ployees. Continue reading

 Reducing Dermal Scarring

Scars are areas of dermal fibrosis that replaces normal tissue after in­jury and during wound healing.

There are several types of dermal scars including:

  1. Atrophic scars that appear as sunken or pitted areas of skin
  2. Hypertophic scars that are charac­terized by raised areas of skin
  3. Keloid scars characterized by growth outside the original wound area
  4. Striae distensae (stretch marks) characterized by linear bands of atrophic-appearing skin.

Dermal ScarringWound healing involves 4 critical phases that overlap: the coagulation phase, the inflammatory phase, the migration-proliferation phase (de­velopment of granulation tissue), and the remodeling-regeneration phase that includes maturation, scar formation and re-epithelialization. The magnitude of the second phase, inflammation, affects the amount of scar tissue that is produced at the conclusion of the healing process. Regeneration is thought of as re­placement of tissue, however, scar formation actually involves a pro­gressive remodeling of granulation tissue. In fact, scars are defined as dermal fibrous replacement tissue that results from a wound that has healed by resolution (rather than re­generation).

Scarring typically occurs following damage to more than 33% of the skin thickness from trauma or surgery. Can skin damaged in this way ever heal without scarring? Actually, com­plete regeneration occurs exclusively in lower vertebrates. Scarless heal­ing in humans only occurs in early embryo development. So, why do we form scars after early development? One theory suggests that wound healing in mammals is optimized for fast healing in a fast-moving, micro­bial-rich environment. Rapid inflam­matory responses may allow quick healing to prevent infections. Continue reading

Handwashing Awareness

washing your handsHandwashing is important because it helps eliminate germs that can cause disease. In fact, good hand hygiene has been linked to a decrease in infectious disease incidence. Unfortunately, it’s too easy to forget the vital importance of handwashing due to the fact that antibiotics and vaccines have contributed so significantly to declining infectious disease-associated mortality over the past 100 years. However, this trend should not be taken for granted, since mortality in the U.S. from infectious diseases actually rose between 1980 and 1992 due to an unexpected increase in emerging infectious diseases such as antibiotic resistant tuberculosis. Continue reading

Fight Cancer With Sleep

Sleeping womanMost people would agree that nothing really beats a great night of restful sleep. Most cells in your body would also agree that they appreciate a good nights rest. However, there are certain types of cells in your body that cannot stand it when you get a full night of great sleep – and those are cancer cells.

We know that sleep is important for feeling rested and energetic during the day, improving mood, immunity, work performance, heart health, cognition – more things than can possibly be imagined. But would you believe that the quality and amount of sleep you get could actually change the way your body responds to certain medications? In fact, as in the case of the breast cancer drug tamoxifen, it could be the difference in treatment success or failure. Continue reading

Food For Thought

Worried woman

Where did I leave my keys?

I know I had something important to do today….

I’m sure I know that person, but why can’t I remember their name?

We all have lapses in our memory from time to time. This is a normal part of life that we are all familiar with, especially as we age.  But what happens when it starts to feel like it might be more than a memory lapse?  What happens when our simple forgetfulness seems to be happening more frequently?

Many people fear that their difficulty remembering things could be the first signs of more serious conditions like dementia or even Alzheimer’s disease. While this might be a very real concern for some people, it is very important to remember that these conditions are distinct from the type of forgetfulness that typically comes with aging. Continue reading

Viniferamine® Energy Support

Energy Support SupplementEnergy Support contains antioxidants, vitamins, and green tea extracts and also includes caffeine to provide energy at the cellular level. Energy Support provides a boost of energy that is safe, effective and quick acting, and it promotes better concentration and improved energy utilization.

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Aloe barbadensis leaf juice

Screen Shot 2014-03-12 at 12.23.12 PMAloe barbadensis leaf juice, an ingredient  used in the Viniferamine Skin & Wound Care System:

Scientific studies suggest that Aloe vera (Aloe barbadensis) enhances wound healing, and several of the studies have emphasized its anti-inflammatory properties.  Many reports also attribute improved healing of burns to treatment with Aloe vera, and it has also been found effective against skin disorders and infections.  In addition, aloe vera has been found to have skin-moisturizing effects.

 

 

References

1.  Semin Integr Med 2003; 1(1): 53-62.

2.  Proc Okla Acad Sci 1879; 58: 69-76.

3.  J Ethnopharmacol 1998; 59: 179-186.

4.  Skin Res Technol 2006 12 (4): 241-246.