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Stomas
Published in Marc A. Levitt, Pediatric Colorectal Surgery, 2023
A surgical glove has been folded around a plastic ring cut from a plastic container, held in place with a fabric band on the top. In the middle is a condom pulled through a hole cut into a sanitary towel. The adhesive on the sanitary towel helps hold this collection device in place. On the bottom, the simplest method is to “double diaper.” The drawback to this method is the risk for excoriation of the surrounding skin if a sufficient amount of barrier cream is not applied.
Urinary tract disorders
Published in Henry J. Woodford, Essential Geriatrics, 2022
Washable pads are usually more cost-effective than disposable ones if they can be reused multiple times (i.e. not for faecal incontinence); they don't contribute as much to landfill but do require laundry. Bigger pads tend to absorb more fluid but are less discreet. Mobile and independent people may prefer smaller pads that they change frequently, especially in social situations. Disposable pads have a top sheet to keep the skin dry, an absorbent core (i.e. fluffed wood pulp fibres mixed with a super-absorbent polymer powder) and a waterproof backing. Washable pads can be traditional terry towelling (cotton) or more modern forms with three layers similar to the disposable ones but with the absorbent core being made of a washable material, such as felt. Fitted pads (e.g. pull-up style pants) come in a range of sizes as well as absorbency ratings. Pant-liner style pads with an adhesive backing are a more discreet. Thinner pads might be okay for people who have bowel leakage alone as less fluid often needs to be absorbed. With faecal incontinence, a barrier cream might help to protect the skin (but change pad ASAP) and washable pads are usually inappropriate.
Chemical Modulation of Topical and Transdermal Permeation
Published in Marc B. Brown, Adrian C. Williams, The Art and Science of Dermal Formulation Development, 2019
Marc B. Brown, Adrian C. Williams
Barrier creams vary from a simple application of petroleum jelly to more elegant formulations. When selecting a barrier cream, it is important to understand the nature of the permeant against which protection is sought, and there are numerous examples in the literature where an inappropriate barrier cream has been ineffective or, worse, delivered the undesired permeant. For example, an in vivo study of three barrier creams protecting against hydrophilic and lipophilic dyes showed that one cream did decrease the amounts of both dyes in the skin samples, another formulation protected against the lipophilic dye but not against the hydrophilic permeant, whereas the third cream formulation increased the levels of both dyes within the tissue (Zhai and Maibach, 1996). Barrier creams tend to be designed to protect against lipophilic permeants such as pesticides and herbicides (since permeation of hydrophilic permeants is inherently relatively low). Barrier preparations are themselves typically lipophilic in order to capture and “trap” the lipophilic agents. However, as occlusive coverings to the skin surface, lipophilic barrier creams can dramatically increase the water content of the stratum corneum, with consequent potential for increased permeant flux as described above.
A 1% colloidal oatmeal OTC cream is clinically effective for the management of mild to moderate atopic dermatitis in Black or African American children
Published in Journal of Dermatological Treatment, 2023
Toni Anne Lisante, Menas Kizoulis, Christopher Nuñez, Corey L. Hartman
In a study in children (N = 90) with mild-to-moderate AD, which included a large subset of Black or African American children (54%), an OTC 1% colloidal oatmeal cream was shown to be equally as effective and safe as a steroid-free prescription barrier cream (9). The prescription ceramide-containing barrier cream includes three essential lipids (ceramides, cholesterol, and free fatty acids), which replenish the skin’s natural level of these lipids to help repair the skin barrier (31). Given the clinical, epidemiologic, and molecular differences among various ethnic phenotypes, it is important to ascertain whether race can affect clinical outcome and whether there are differences in the performance of an OTC cream compared with standard prescription treatment. Herein we report the findings of a post hoc analysis evaluating the effectiveness and safety of the 1% colloidal oatmeal cream in the cohort of Black or African American children with mild-to-moderate AD in the aforementioned study.