[Effectiveness of topical acetate tocopherol for the prevention and treatment of skin lesions in newborns: a 5 years experience in a 3rd level Italian Neonatal Intensive Care Unit].
OBJECTIVE
Neonates in NICU (especially when premature) are particularly prone to skin damage by action of external aggressive conditions such as chemical, physical, infectious, radiant, mechanical and iatrogenic factors. Strategies for avoiding disruption of the skin barrier are thus highly needed in such patients.


METHODS
We evaluated the effectiveness of a acetate tocopherol (AT) ointment for topical use in 21 neonates admitted to our NICU and affected by neonatal abstinence syndrome with severe diaper exulcerative and erosive erythema with ulcer and granulation tissue at the bottom of the lesion (group A), and compared them to 19 matched neonates affected by the same condition and treated with a commonly used skin ointment (emollient type, water-in-oil category) (group B). For all newborns we calculated: the dermatological severity score (using a clinical score from 0 to 9 points according to the increasing severity of the lesions) at time 0, 4 and 7 days; the mean days for achieving complete recovery; the rate of therapeutical failures.


RESULTS
Mean score at day 0 was 7.8 in group A vs 7.9 in group B (P=0.35 NS). At day 4 it was 4.6 in group A vs 6.5 in group B (P=0.03), at day in 7 it was 3.1 in group A vs 5.2 in group B (P=0.04). A complete recovery with restitutio ad integrum occurred after 9.1 mean days in group A vs 12.2 mean days in group B (P=0.04). The rate of therapeutical failures was significantly lower in group A (4.2% vs 30.6%; OR 0.235; P<0.01) than in group B. No adverse effects related to AT use were reported.


CONCLUSIONS
AT in our experience proved to be safe and more effective than the commonly used skin ointments in the topical treatment of exulcerative skin lesions in NICU neonates.
Manzoni
P
P
Divisione di Neonatologia e TIN Ospedaliera, Ospedale S. Anna, Azienda Ospedale OIRM-S. Anna, Turin. paolomanzoni@hotmail.com
Gomirato
G
G
D003963:Diaper Rash / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D007363:Intensive Care Units, Neonatal; D009357:Neonatal Abstinence Syndrome / Q000188:drug therapy*; D009824:Ointments; D012720:Severity of Illness Index; D013997:Time Factors; D024505:Tocopherols; D016896:Treatment Outcome; D024502:alpha-Tocopherol / Q000008:administration & dosage / Q000031:analogs & derivatives*
D009824:Ointments; D024502:alpha-Tocopherol; D024505:Tocopherols