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  1. Article: Associations between skin structural and functional changes after loading in healthy aged females at sacral and heel skin: A secondary data analysis.

    Völzer, Bettina / Kottner, Jan

    Journal of tissue viability

    2022  Volume 31, Issue 2, Page(s) 239–244

    Abstract: Aim of the study: Mechanical loading causes skin occlusion and deformation, which influences structural and functional skin properties. Aims of the study were to measure structural and functional skin parameters after loading at the sacral and heel skin ...

    Abstract Aim of the study: Mechanical loading causes skin occlusion and deformation, which influences structural and functional skin properties. Aims of the study were to measure structural and functional skin parameters after loading at the sacral and heel skin and to describe possible associations.
    Material and methods: A secondary data analysis based on a clinical trial with n = 15 aged women was conducted. Changes of transepidermal water loss, stratum corneum hydration, epidermal hydration, erythema, temperature, structural stiffness, elastic recovery, elastic function, and mean roughness after 120 min loading were described and compared. Spearman's rho (r
    Results: Loading caused an increase of transepidermal water loss, stratum corneum and epidermal hydration, erythema and temperature at sacral and heel skin. There was a decrease of median roughness at the heel skin surface (-8.5 (IQR -10.5 to 5.5) μm). Strongest positive associations were observed between changes of elastic function and elastic recovery (r
    Conclusion: Two hours loading on a standard foam mattress leads to skin occlusion at the skin surface and mechanical deformation. Skin occlusion seems primarily to increase temperature, stratum corneum and epidermal hydration that may affect mechanical skin properties. Mechanical deformation seems to be responsible for the erythematous response of the dermal skin layer.
    MeSH term(s) Aged ; Data Analysis ; Female ; Heel ; Humans ; Pressure Ulcer ; Skin ; Water
    Chemical Substances Water (059QF0KO0R)
    Language English
    Publishing date 2022-02-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 1282604-2
    ISSN 0965-206X
    ISSN 0965-206X
    DOI 10.1016/j.jtv.2022.01.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Skin care types, frequencies and products: A cross-sectional study in German institutional long-term care.

    Amin, Ruhul / Völzer, Bettina / El Genedy-Kalyoncu, Monira / Blume-Peytavi, Ulrike / Kottner, Jan

    Journal of tissue viability

    2024  

    Language English
    Publishing date 2024-02-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 1282604-2
    ISSN 0965-206X
    ISSN 0965-206X
    DOI 10.1016/j.jtv.2024.02.005
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    In stock of ZB MED Cologne/Königswinter

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  3. Article ; Online: The prevalence and severity of dry skin and related skin care in older adult residents in institutional long-term care: A cross-sectional study.

    Amin, Ruhul / Völzer, Bettina / Genedy-Kalyoncu, Monira El / Blume-Peytavi, Ulrike / Kottner, Jan

    Geriatric nursing (New York, N.Y.)

    2023  Volume 54, Page(s) 331–340

    Abstract: Objectives: To identify possible factors associated with different severities of xerosis cutis and to describe possible associations between (skin) care dependency and application of moisturizers.: Design: Cross-sectional study using baseline data ... ...

    Abstract Objectives: To identify possible factors associated with different severities of xerosis cutis and to describe possible associations between (skin) care dependency and application of moisturizers.
    Design: Cross-sectional study using baseline data from a cluster-randomized controlled trial. Demographic and health characteristics, skin physiological measurements, functional abilities and application of moisturizers were compared between the participants with mild and severe dry skin. Frequency of moisturization were also compared based on the participants' skin care dependency.
    Results: The more distal the body area, the more severe xerosis were observed. There were no or minor differences between the groups, except for the stratum corneum hydration and skin surface pH. Participants with severe xerosis received moisturizers less often. Skin care dependent residents received moisturizers frequently.
    Conclusion: There is under-application regarding xerosis cutis treatment in long-term care. Skin care provided by nurses, in adequate frequencies, might be helpful compared to skin care performed by the residents themselves.
    MeSH term(s) Aged ; Humans ; Activities of Daily Living ; Cross-Sectional Studies ; Long-Term Care ; Prevalence ; Skin Care ; Randomized Controlled Trials as Topic
    Language English
    Publishing date 2023-11-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632559-2
    ISSN 1528-3984 ; 0197-4572
    ISSN (online) 1528-3984
    ISSN 0197-4572
    DOI 10.1016/j.gerinurse.2023.10.032
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  4. Article ; Online: Prevalence and associations of xerosis cutis, incontinence-associated dermatitis, skin tears, pressure ulcers, and intertrigo in aged nursing home residents: A representative prevalence study.

    Völzer, Bettina / El Genedy-Kalyoncu, Monira / Fastner, Alexandra / Tomova-Simitchieva, Tsenka / Neumann, Konrad / Sill, Janna / Balzer, Katrin / Kottner, Jan

    International journal of nursing studies

    2023  Volume 141, Page(s) 104472

    Abstract: Background: The number of elderly and care-dependent people is increasing, leading to increased risks of adverse skin conditions. Skin care, including prevention and treatment of vulnerable skin, is an essential part of daily nursing practice in long- ... ...

    Abstract Background: The number of elderly and care-dependent people is increasing, leading to increased risks of adverse skin conditions. Skin care, including prevention and treatment of vulnerable skin, is an essential part of daily nursing practice in long-term residential settings. For many years, the research focus has been on individual skin problems including xerosis cutis, incontinence-associated dermatitis, skin tears, pressure ulcers, and intertrigo, although people may be affected by several at the same time.
    Objectives: Aim of the present study was to describe the prevalence and associations of skin conditions relevant to nursing practice in aged nursing home residents.
    Design: Analysis of baseline data of a cluster-RCT in long-term residential settings.
    Setting: The study was conducted in a representative sample of n = 17 nursing homes in the federal state of Berlin, Germany.
    Participants: Care dependent nursing home residents being 65+ years.
    Methods: A random sample of all eligible nursing homes was drawn. Demographic and health characteristics were collected and head-to-toe skin examinations conducted by dermatologists. Prevalence estimates and intracluster correlation coefficients were calculated, and group comparisons conducted.
    Results: Three hundred fourteen residents with a mean age of 85.4 (SD 7.1) years were included. The majority was affected by xerosis cutis (95.9%, 95% CI 93.6 to 97.8), followed by intertrigo 35.0% (95% CI 30.0 to 40.1), incontinence-associated dermatitis 21.0% (95% CI 15.6 to 26.3), skin tears 10.5% (95% CI 7.3 to 13.8), and pressure ulcers 8.0% (95% CI 5.1 to 10.8). In total, more than half of the nursing home residents were affected by two or more skin conditions at the same time. Several associations between skin conditions and mobility, care dependency, or cognitive impairment were observed. There were no associations between xerosis cutis, incontinence-associated dermatitis, skin tears, pressure ulcers or intertrigo.
    Conclusions: The adverse skin and tissue conditions xerosis cutis, incontinence-associated dermatitis, skin tears, pressure ulcers and intertrigo are very common in long-term residential settings, placing a high burden on this population. Although care receivers share similar risk factors and may be affected by several skin conditions at the same time, there are no associations indicating separate aetiological pathways.
    Registration: This study is registered at the German Clinical Trials Register (registration number: DRKS00015680; date of registration: January 29th, 2019) and ClinicalTrials.gov (NCT03824886; date of registration: January 31st, 2019).
    MeSH term(s) Aged ; Humans ; Aged, 80 and over ; Pressure Ulcer/epidemiology ; Cross-Sectional Studies ; Prevalence ; Nursing Homes ; Skin Diseases ; Intertrigo
    Language English
    Publishing date 2023-02-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 80148-3
    ISSN 1873-491X ; 0020-7489
    ISSN (online) 1873-491X
    ISSN 0020-7489
    DOI 10.1016/j.ijnurstu.2023.104472
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  5. Article ; Online: Comparison of two skin protection regimes for the Prevention of Incontinence-associated Dermatitis in geriatric care (PID): a study protocol for an exploratory randomised controlled pragmatic trial.

    El Genedy-Kalyoncu, Monira / Fastner, Alexandra / Völzer, Bettina / Raeder, Kathrin / Neumann, Konrad / Lahmann, Nils Axel / Kottner, Jan

    BMJ open

    2022  Volume 12, Issue 9, Page(s) e065909

    Abstract: Introduction: The majority of aged long-term care receivers and patients in geriatric acute care are affected by some form of incontinence. These individuals are at risk of developing incontinence-associated dermatitis (IAD), a common type of irritant ... ...

    Abstract Introduction: The majority of aged long-term care receivers and patients in geriatric acute care are affected by some form of incontinence. These individuals are at risk of developing incontinence-associated dermatitis (IAD), a common type of irritant contact dermatitis caused by repeated and prolonged direct contact of the skin with urine and stool. The prevalence of IAD in these settings is high. Preventive measures include mild skin cleansing and the application of skin protecting leave-on products. Available evidence is weak regarding the comparative performance of different skin protection strategies and products due to a lack of confirmatory trials using relevant comparators and endpoints. Therefore, the overall aim of this exploratory trial is to compare the effects of three skin protection strategies to estimate effect sizes of the recently published core outcomes in IAD research.
    Methods and analysis: A pragmatic three-arm, assessor-blinded, randomised controlled, exploratory trial with parallel group design will be performed, comparing film-forming and lipophilic skin protecting leave-on products for IAD prevention with standard incontinence care alone. The trial will be conducted in geriatric nursing homes and geriatric acute care settings in the federal state of Berlin, Germany. A total of n=210 participants being incontinent of urine and stool will be included. Outcomes include IAD incidence, erythema, erosion, maceration, IAD-related pain, patient satisfaction, safety, feasibility and compliance. IAD incidence of the control and intervention groups will be compared to estimate effect sizes, and the procedural feasibility of the intervention will be tested to plan a possible subsequent confirmatory randomised controlled trial.
    Ethics and dissemination: The study received the approval of the ethics committee of Charité-Universitätsmedizin Berlin (EA4/043/22). Results will be disseminated through peer-reviewed open-access journals and international conferences.
    Trial registration number: ClinicalTrials.gov (NCT05403762) and German Clinical Trials Register (Deutsches Register Klinischer Studien, or DRKS) (DRKS00028954).
    MeSH term(s) Aged ; Body Fluids ; Dermatitis/etiology ; Dermatitis/prevention & control ; Feces ; Humans ; Irritants ; Randomized Controlled Trials as Topic ; Skin
    Chemical Substances Irritants
    Language English
    Publishing date 2022-09-29
    Publishing country England
    Document type Clinical Trial Protocol ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2022-065909
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  6. Article ; Online: Enhancing skin health and safety in aged care (SKINCARE trial): A cluster-randomised pragmatic trial.

    Völzer, Bettina / El Genedy-Kalyoncu, Monira / Fastner, Alexandra / Tomova-Simitchieva, Tsenka / Neumann, Konrad / Hillmann, Kathrin / Blume-Peytavi, Ulrike / Hahnel, Elisabeth / Sill, Janna / Balzer, Katrin / Kottner, Jan

    International journal of nursing studies

    2023  Volume 149, Page(s) 104627

    Abstract: Background: Older nursing home residents are prone to develop different skin conditions at the same time, including xerosis cutis, skin tears, pressure ulcers, incontinence-associated dermatitis or intertrigo. Guidelines and recommendations mainly ... ...

    Abstract Background: Older nursing home residents are prone to develop different skin conditions at the same time, including xerosis cutis, skin tears, pressure ulcers, incontinence-associated dermatitis or intertrigo. Guidelines and recommendations mainly address these skin conditions separately. The overall aim of this study was to measure the effects of the implementation of a skincare and prevention package.
    Trial design: A two-arm cluster-randomised controlled trial was conducted.
    Methods: In nursing homes being assigned to the intervention group, an evidence-based and structured skincare and prevention programme was implemented for six months. Nursing home residents in the control group received standard care as usual. Blinded dermatologists conducted head-to-toe skin assessments, and the researchers assessed skin barrier parameters including stratum corneum hydration and transepidermal water loss at the upper and lower extremities after three and six months. Outcomes included the cumulative incidence of incontinence-associated dermatitis, skin tears, pressure ulcers and intertrigo, and were presented as intention-to-treat and per protocol analysis. Skin dryness and resident-reported outcomes (pain, itch, quality of life) were assessed.
    Results: A random sample of 17 nursing homes in the federal state of Berlin, Germany, was drawn and randomised in intervention (n = 9) and control groups (n = 8). In total, 165 participants were allocated to the intervention, and 149 participants were allocated to the control group. The cumulative incidence of skin tears (19.2 %, 95 % CI 12.8-27.8), pressure ulcers (13.6 %, 95 % CI 8.1-21.9) and intertrigo (27.0 %, 95 % CI 18.4-37.7) was lower in the intervention compared to the control group, with cumulative incidences of 27.2 % (95 % CI 19.3-36.9) for skin tears, 16.9 % (95 % CI 10.6-25.9) for pressure ulcer, and 37.8 % (95 % CI 27.5-49.4) for intertrigo. The incidence of incontinence-associated dermatitis was higher in the intervention group (26.3 %, 95 % CI 17.9-36.8) compared to the control group (23.1 %; 95 % CI 14.6-34.5). Mean skin dryness was lower in the intervention group but showed variation. The impact on pain, itch, and quality of life was trivial.
    Conclusions: The present study results indicate that the implementation of tailored and evidence-based nursing routines improves skin health and safety in residential long-term care. Evidence suggests that multiple adverse skin conditions can be prevented by regular skin assessments and individually tailored skincare routines. Positive effects on skin dryness were observed, but skin physiology parameters did not indicate changes of the skin barrier function.
    Trial registration: This study is registered at the German Clinical Trials Register (registration number: DRKS00015680; date of registration: January 29
    MeSH term(s) Humans ; Aged ; Pressure Ulcer/prevention & control ; Pressure Ulcer/epidemiology ; Quality of Life ; Skin ; Intertrigo ; Pain
    Language English
    Publishing date 2023-10-28
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 80148-3
    ISSN 1873-491X ; 0020-7489
    ISSN (online) 1873-491X
    ISSN 0020-7489
    DOI 10.1016/j.ijnurstu.2023.104627
    Database MEDical Literature Analysis and Retrieval System OnLINE

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