Incontinence-associated dermatitis（IAD）is a common problem in men with urinary incontinence. Although absorbent pads have been used to manage urinary incontinence（UI）and prevent IAD, pad leakage occurs and increases the risk of IAD. The aim of this study was to develop and evaluate a new pouch product, for men with urinary incontinence. This study contained model and healthy volunteer experiments that were conducted to examine and compare the management of UI using absorbent pads（the AP group）or a pouch（the Pouch group）. Urine leakage rates, skin physiological properties, and user satisfaction were evaluated in healthy volunteers. The pad leakage rate was significantly lower in the Pouch group in both the model and healthy volunteer experiments. Time course changes in skin hydration and pH were significantly higher in the AP group than in the Pouch group. User satisfaction including comfort after voiding urine, itchiness, and odor was significantly higher in the Pouch group than in the AP group. The results of the present study showed that the management of UI with a pouch decreased pad leakage and preserved skin properties, which may reduce the risk of IAD. Moreover, user satisfaction was higher with the pouch than with the absorbent pads. Our results suggest that this pouch may have potential as a new product for the management of UI and IAD prevention.
Obesity increases the prevalence of chronic wounds and inflammatory skin diseases. Animal experiments have shown that increased oxidative stress induces the overexpression of collagenases in subcutaneous adipose tissues, resulting in the degradation of dermal collagen with obesity. This clinical study investigated the relationships between dermal structural changes and both oxidative stress and tissue denaturation in the subcutaneous fat of obese individuals. A total of 61 male volunteers recruited from private companies and a general hospital were classified into three groups according to body mass index（BMI）: <25; 25-30; and≥30. Ultrasound images of the dermis and subcutaneous tissues were obtained. Expression of the heme oxygenase 1（HMOX1）gene in hair follicles was measured as a marker for oxidative stress by a real-time reverse transcription polymerase chain reaction（RT-PCR）. The dermal structures of subjects were classified into three types（A-C）based on the thickness and distribution of hyperechogenic spots on ultrasonography. Types B and C were increased in subjects with a BMI≥25, whereas approximately 80% of subjects with BMI <25 were type A. The expression of HMOX1 and tissue denaturation of subcutaneous fat were significantly higher in type B and C subjects than in type A subjects. We revealed an association between dermal structural changes and both increased hair follicle oxidative stress and fat tissue denaturation in obese males. These findings suggest that assessing skin in the early stages of obesity is warranted, and skin treatment with antioxidants, at least in obese males, may prevent skin problems.
Support surfaces are used to control external pressures acting on bony prominences; however, because of the tightness of sheets spread out on a mattress, a hammock effect can occur that causes pressure ulcers. This study elucidated the effects of differences in bed-making methods on the pressure redistribution of an air mattress. The internal pressure of a static air mattress was set to 25 mmHg, and a 100% cotton plain weave sheet was spread out on the mattress. A buttock model was placed on this mattress and a vertical load was applied. The immersion distance, contact area, and maximum interface pressure（MIP）were measured. Bed-making methods were classified as the "corner method", in which the sheet corners were folded in and under in a triangular fashion; the "no treatment method", in which the corners were untreated; the "tying method", in which the sheet corners were folded in and under the back of the mattress and knotted; and the "no sheet method", in which only the cover of the air mattress was used. Data were analyzed using a one-way analysis of variance between the treatment comparisons and multiple comparison tests were also used. The corner method lowered the contact area to 0.6 relative to the "no treatment method", increased the MIP value 1.9-fold, and disturbed the pressure redistribution functionality of the mattress. The "tying method" affected pressure redistribution functionality in the same manner. These results suggest that the corner treatment of sheets affects the pressure redistribution functionality of air mattresses.
The aim of this study was to develop a novel wound dressing composed of a hyaluronic acid（HA）spongy sheet containing epidermal growth factor（EGF）, arginine（Arg）, and a vitamin C derivative（VC）. The wound dressing prepared by a freeze-drying method had a two-layered structure: an upper layer composed of cross-linked high-molecular-weight HA（cHMW-HA）and a lower layer composed of low-molecular-weight HA（LMW-HA）containing Arg and VC（Group I : EGF（－）dressing）. The wound dressing containing EGF was prepared in a similar manner（Group II : EGF（+）dressing）. To create a wound surface model, a fibroblast-incorporating collagen gel was elevated to the air-liquid interface, on which each wound dressing was placed and cultured. Cell metabolic activity and the production of vascular endothelial growth factor（VEGF）and hepatocyte growth factor（HGF）were measured using an MTT assay and ELISA, respectively. The Group II dressing enhanced fibroblast metabolic activity, and also stimulated fibroblasts to release an increased amount of VEGF and HGF. In addition, each wound dressing was applied to a full-thickness skin defect in the abdominal region of SD rats. Wound conditions were evaluated based on gross and histological appearances. An alginate wound dressing was used in the control group. Both Group I and II dressings promoted granulation tissue formation associated with angiogenesis, and consequently the size of wounds was smaller in these groups than in the control group. The Group II dressing in particular lessened the inflammatory reaction at an earlier stage. These findings indicate that the EGF-incorporating wound dressing（Group II）has the potential to facilitate wound healing.