Background: Zinc oxide ointment may be difficult to use on loose or wrinkled skin in patients with incontinence-associated dermatitis （IAD）. A skin protectant featuring polymer-cyanoacrylate technology that coats erosions has been used for IAD and is expected to be useful for loose or wrinkled skin as well.
　Objective: To compare the efficacy of zinc oxide ointment and the cyanoacrylate-blended coating agent in elderly dialysis patients with severe IAD.
　Method: The present, retrospective, cohort study included nine patients receiving zinc oxide ointment and 12 patients receiving the coating agent. The IAD-set scores were evaluated weekly for up to 49 days.
　Results: The IAD-set score was 11.0 （9-18）in the ointment group and 11.0 （5-18）in the coating agent group on day 0 of the intervention（p = 0.808）. On day 7, the score was 11.0 （6-17）and 6.0 （0-16）（p = 0.031）, and on day 14, it was 10.5 （6-19）and 5.0 （0-14）（p = 0.034）for the respective group.
　Changes in the unhealed rate suggested that the cyanoacrylate-blended coating agent was significantly more effective （p = 0.004）.
　Discussion: Friction removed the zinc oxide ointment from the skin, rendering it ineffective in treating IAD. However, the coating agent adhered to loose and wrinkled skin, including the areas affected by erosion, and was able to protect it from irritants.
　Conclusion: The present study revealed that the cyanoacrylate-blended skin protectant was effective for treating severe IAD.

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Background
　Docetaxel is a key anticancer drug for the treatment of breast cancer. Edema is a known side effect of treatment. In patients with breast cancer, the treatment of edema focuses on that of lymphedema. To establish treatment for the edemas caused by docetaxel therapy in breast cancer patients, this study aimed to summarize the evidence on the clinical features of such edemas.
Methods
　A scoping review design was used. We limited our search to articles titles published in English. We included studies involving participants of all ages and at all stages of breast cancer. We searched the PubMed, CINAHL, and Cochrane Central databases for articles published between January 2006 and July 2021.
Results
　A total of 283 articles were found, and eight papers were deemed eligible for inclusion. The site of edema formation was mainly the upper and lower limbs. Edema appeared three weeks after the end of the docetaxel regimen, and edema in the legs and arm on the contralateral side of the surgery returned to the pre-docetaxel level after 6 months of chemotherapy.
Conclusion
　It was difficult to distinguish edema of the upper limbs due to docetaxel in patients with breast cancer from lymphedema due to lymph node dissection. In order to establish management strategies of docetaxel-related edema, it is necessary to characterize lower-limb edema, which are not affected by lymph node dissection.

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　Discontinuation of treatment of diabetic foot ulcers may impair wound healing. However, the factors related to discontinuation of wound clinic visits by patients with diabetic foot ulcers are unclear. Thus, measures for the prevention of treatment discontinuation remain to be elucidated. This prospective study aimed to investigate time required for healing, cost, and quality of life when the treatment was continued until recovery, and to clarify factors associated with the discontinuation of clinic visits. A total of 73 participants with diabetic foot ulcers were enrolled, including 15 participants with healed ulcers and 58 participants who discontinued wound care specialist clinic visits. The cumulative clinic visit discontinuation rate at 10 days was 51%. The average wound healing time was 31.5±21.0 days and the total cost was $150.20±118.84. The average utility score and visual analog scale score for perception of overall health at baseline were 0.55±0.20 and 69.67±11.87, and at recovery were 0.91±0.16 and 93.00±5.92, respectively. The factors associated with clinic visit discontinuation were low monthly income（hazard ratio: 1.87, 95% confidence interval［CI］: 1.02-3.43, p = 0.044）and lower satisfaction with access to health services（hazard ratio: 5.06, 95% CI: 2.34-10.97, p < 0.001）. The introduction of an insurance system to subsidize at least 69.7% of diabetic foot ulcer treatment costs is necessary, and treatment of diabetic foot ulcers by encouraging continuation of clinic visits will help improve patients’ quality of life.

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　Background: Reliable, consistent, and accurate wound description and documentation are essential wound assessment components. This wound assessment provides wound-care specialists adequate information for clinical decision-making regarding local wound-care. One of the unique characteristics on the wound edge of a diabetic foot ulcer（DFU）is a red ring. However, its morphological characteristics and risk factors are still unclear.
　Purpose: This study aimed to describe the red ring characteristics and explore factors related to its occurrence.
　Methods: This study was a secondary analysis of two cohort studies regarding DFU wound healing at a wound-care clinic in Indonesia. Using the data of 35 patients with DFU from two studies, we conducted a qualitative descriptive study and a cross-sectional study. The qualitative study was conducted using morphoqualitative analysis. In the cross-sectional study, we compared the patients’ and wounds’ data between with and without a red ring.
　Results: A total of 10 of 35 patients with DFU had red lines on the wound edges. Bright red lines appeared on the wound edge along with slough. Regarding the factors related to red lines, scores of DMIST depth, maceration, inflammation or infection, and tissue type of wound bed were significantly more severe in patients with DFU with red lines than in those patients with DFU without red lines.
　Conclusion: The red line occurrence on the DFU wound edge might be related to local wound infection. Thus, nurses should pay more attention to the red lines of the DFU wound edge to prevent wound deterioration.

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　Aim：Nutritional intervention for malnutrition is essential in the management of patients with pressure injuries. We have recently developed a real-time and non-invasive method to evaluate the temporal muscle thickness（TMT）for nutritional assessment and monitoring. We report the case of a patient with a pressure injury, in whom nutritional management was undertaken using ultrasonographic monitoring of the TMT in a home care setting.
　Methods：A 90-year-old bedridden female with a pressure injury on the sacrum was referred to a dietitian for nutritional intervention. The Braden scale score was 9 points, and the DESIGN-R^® score was 24 points（D4-E6s6I3G6N3p0）. The patient showed signs of malnutrition; unintentional weight loss（4.7%/6 months）, the BMI of 19.3 kg/m², the TMT of 3.8 mm, and hypoalbuminemia（3.3 g/dL）. The daily nutritional goal was 1369-1597 kcal, and 57-68 g protein as per NPUAP/EPUAP guidelines, although her baseline daily intake was only 1375 kcal and 38 g protein. Therefore, daily intake of a high-calorie high-protein oral nutritional supplement（ONS）containing 200 kcal was prescribed. After two weeks, since the TMT was further decreased, the ONS was increased to 400 kcal daily. Thereafter, the TMT increased to 4.3 mm, weight increased to the BMI of 20.3 kg/m², and the serum albumin level became 3.5 g/dL. The pressure injury healed by 12 weeks.
　Discussion/Conclusions: Ultrasonographic monitoring of the TMT enabled real-time and noninvasive assessment of the energy adequacy, and could be useful for nutritional management of patients with pressure injuries in home care settings.

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