Semipermeable dressings improve epidermal barrier function in premature infants.
Infants of less than 32 wk gestation have a defective epidermal barrier, with increased skin permeability and transepidermal water loss (TEWL). We studied the effect of a nonadhesive semipermeable dressing on the epidermal barrier of premature infants and on fetal skin transplanted to nude mice. Fifteen infants with a mean estimated gestational age of 27.7 wk and 16 human fetal skin grafts (estimated gestational age, 23-26 wk) transplanted to eight nude mice were studied. One lower leg (or skin graft) was treated and the other left untreated as a control. In the infants, TEWL was measured on control skin and treated skin (both through the dressing and after temporary dressing removal) on d 0, 1, 2, 4, and 7. Bacterial and fungal cultures were also performed. In the mice, TEWL and skin blood flow were measured on d 0, 2, and 4. Biopsies were obtained on d 4 for a cell proliferation assay, histology, and electron microscopy. Treated infant skin showed a consistently lower bacterial number and a significantly decreased TEWL (measured through the dressing). There was also a significantly lower TEWL on the treated side, measured after temporary dressing removal, on d 1, 2, 4, and 7, documenting improved epidermal barrier function. The animal study revealed decreased TEWL and a nearly 2-fold greater d-4 keratinocyte proliferation (p = 0.01) in treated skin and decreased blood flow on d 4 in control skin (p = 0.01). There was no significant difference in the volume density of membrane coating granules or the morphology of intercorneocyte spaces.(ABSTRACT TRUNCATED AT 250 WORDS)
Mancini
A J
AJ
Department of Dermatology, Stanford University School of Medicine, California 94305-5486.
Sookdeo-Drost
S
S
Madison
K C
KC
Smoller
B R
BR
Lane
A T
AT
D000818:Animals; D001458:Bandages; D002455:Cell Division / Q000502:physiology; D004817:Epidermis / Q000378:metabolism*; D005260:Female; D016332:Fetal Tissue Transplantation / Q000502:physiology; D006652:Histological Techniques; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D015603:Keratinocytes / Q000166:cytology; D008297:Male; D051379:Mice; D008819:Mice, Nude; D008854:Microscopy, Electron; D010539:Permeability; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply; D016038:Skin Transplantation / Q000502:physiology