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Elevated skin pH is associated with an increased permeability to synthetic urine

Elevated skin pH is associated with an increased permeability to synthetic urine
Elevated skin pH is associated with an increased permeability to synthetic urine

PURPOSE: The aim of this study was to investigate the permeability of the skin following cleansing activities and its susceptibility to synthetic urine penetration. SUBJECTS AND SETTING: Ten healthy volunteers (aged 22-58 years) participated in the study, which was conducted in a university bioengineering laboratory. METHODS: Tape stripping and sodium lauryl sulfate were used to simulate the physical and chemical irritation exacerbated by frequent cleansing activities, respectively. An untreated site also was selected to evaluate responses of intact skin. Synthetic urine was then applied for a period of 2 hours. Measurements of transepidermal water loss and skin pH were taken at baseline and after each challenge. To quantify the permeability of the skin following exposure, desorption curves of transepidermal water loss were measured and skin surface water loss was calculated. RESULTS: Chemically irritated skin, characterized by increased pH (7.34 ± 0.22), demonstrated an increased permeability to urine, as reflected by a significant increase in mean skin surface water loss (46,209 ± 15,596 g/m 2) compared to both the intact (14,631 ± 6164 g/m 2) and physically irritated (14,545 ± 4051 g/m 2) skin (P =.005 in both cases). In contrast, the differences between the intact and physically irritated skin were not significant (P =.88). CONCLUSION: Permeability of the skin to irritants is influenced by the status of the skin and its acid mantle. These highlight the need to reevaluate the frequency of cleansing activities, along with the choice of product in clinical settings, favoring the use of pH-balanced cleansers.

Acid mantle, Frequent cleansing, Incontinence-associated dermatitis, Moisture-associated skin damage, Pathophysiology, Skin care, Skin permeability, Urinary incontinence
1071-5754
61-67
Koudounas, Sofoklis
052f50e1-2ef7-487d-8ba2-a60048bae0fc
Bader, Dan L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Voegeli, David
e6f5d112-55b0-40c1-a6ad-8929a2d84a10
Koudounas, Sofoklis
052f50e1-2ef7-487d-8ba2-a60048bae0fc
Bader, Dan L.
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Voegeli, David
e6f5d112-55b0-40c1-a6ad-8929a2d84a10

Koudounas, Sofoklis, Bader, Dan L. and Voegeli, David (2021) Elevated skin pH is associated with an increased permeability to synthetic urine. Journal of Wound, Ostomy and Continence Nursing, 48 (1), 61-67. (doi:10.1097/WON.0000000000000716).

Record type: Article

Abstract

PURPOSE: The aim of this study was to investigate the permeability of the skin following cleansing activities and its susceptibility to synthetic urine penetration. SUBJECTS AND SETTING: Ten healthy volunteers (aged 22-58 years) participated in the study, which was conducted in a university bioengineering laboratory. METHODS: Tape stripping and sodium lauryl sulfate were used to simulate the physical and chemical irritation exacerbated by frequent cleansing activities, respectively. An untreated site also was selected to evaluate responses of intact skin. Synthetic urine was then applied for a period of 2 hours. Measurements of transepidermal water loss and skin pH were taken at baseline and after each challenge. To quantify the permeability of the skin following exposure, desorption curves of transepidermal water loss were measured and skin surface water loss was calculated. RESULTS: Chemically irritated skin, characterized by increased pH (7.34 ± 0.22), demonstrated an increased permeability to urine, as reflected by a significant increase in mean skin surface water loss (46,209 ± 15,596 g/m 2) compared to both the intact (14,631 ± 6164 g/m 2) and physically irritated (14,545 ± 4051 g/m 2) skin (P =.005 in both cases). In contrast, the differences between the intact and physically irritated skin were not significant (P =.88). CONCLUSION: Permeability of the skin to irritants is influenced by the status of the skin and its acid mantle. These highlight the need to reevaluate the frequency of cleansing activities, along with the choice of product in clinical settings, favoring the use of pH-balanced cleansers.

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More information

e-pub ahead of print date: 13 November 2020
Published date: 1 January 2021
Keywords: Acid mantle, Frequent cleansing, Incontinence-associated dermatitis, Moisture-associated skin damage, Pathophysiology, Skin care, Skin permeability, Urinary incontinence

Identifiers

Local EPrints ID: 446642
URI: http://eprints.soton.ac.uk/id/eprint/446642
ISSN: 1071-5754
PURE UUID: 959927ee-6243-41eb-b0d4-6ba44a72728c
ORCID for Dan L. Bader: ORCID iD orcid.org/0000-0002-1208-3507
ORCID for David Voegeli: ORCID iD orcid.org/0000-0003-3457-7177

Catalogue record

Date deposited: 17 Feb 2021 17:30
Last modified: 16 Mar 2024 10:59

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Contributors

Author: Sofoklis Koudounas
Author: Dan L. Bader ORCID iD
Author: David Voegeli ORCID iD

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