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Novel and Rapid Method for Quantification of Stratum Corneum Disruption by Adhesive Wound Dressings

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Title: Novel and Rapid Method for Quantification of Stratum Corneum Disruption by Adhesive Wound Dressings


1
Novel and Rapid Method for Quantification of
Stratum Corneum Disruption by Adhesive Wound
Dressings Magnus S. Ågren¹, Åsa Rosqvist² and
Maria Werthén² ¹Department of Surgery K,
Bispebjerg Hospital, Copenhagen University
Hospital, Copenhagen, Denmark, and ²Mölnlycke
Health Care AB, Gothenburg, Sweden
  • Background
  • Stratum corneum is the outermost layer of the
    skin
  • Stratum corneum maintains the water and
    electrolyte homeostasis, and protects from
    entrance of micro-organisms and toxic agents
  • Stratum corneum comprises layers of keratinized
    corneocytes
  • Keratin proteins account for at least 80 of the
    corneocyte mass
  • Frequent changes of adhesive dressings can
    damage the skin barrier due to removal of
    corneocytes 1
  • Transepidermal water loss (TEWL) is the gold
    standard for the indirect non-invasive
    measurement of disruptions of the skin barrier
    function but is cumbersome and show high
    variability.
  • Aim
  • To evaluate the potential of estimating the
    amount of stratum corneum removed by the
    different types of adhesives of dressings by
    protein analysis.

Materials and methods
  • Results
  • Corneocyte removal, measured indirectly as
    protein, varied among the different dressing
    adhesives over time (Fig. 3). The constant rate
    in the Mepilex Border group most likely reflects
    the basal steady-state desquamation.
  • Patients
  • 10 (7 females) healthy volunteers
  • Aged 20-61 years (41 4 years, mean SEM)
  • Dressing adhesives tested
  • Allevyn Adhesive (Smith Nephew)
  • Biatain Adhesive (Coloplast)
  • Cellosorb Adhesive (Urgo)
  • DuoDERM Extra Thin (ConvaTec)
  • Mepilex Border (Mölnlycke Health Care)
  • Tielle (Johnson Johnson)

Fig. 3. Corneocyte removal measured as protein
content of used dressing adhesive (mean SEM).
  • Treatment
  • Dressing adhesives randomized to 6 positions on
    posterior lower leg
  • (Fig. 1)
  • Dressings applied and removed every second to
    third day for 11 days
  • Cumulative corneocyte removal was lowest with
    Mepilex Border and highest with DuoDERM (Table
    I).

Fig. 1. Test adhesive patches applied to the
lower leg. Dressings were covered with Tubifast.
Table I. Total stratum corneum removal, measured
as cumulative protein, by dressing adhesives over
the 11-day experimental period arranged in
ascending order (mean SEM).
  • Protocol for protein extraction and determination
    2
  • Extraction and analyses were carried out in
    96-well plates (Fig. 2)
  • Conclusions
  • The method presented here was simple, fast and
    precise in quantification of adherent corneocytes
    to the adhesives of wound dressings.
  • The six examined dressing adhesives can be ranked
    according to their ability to remove corneocytes
    from skin as follows
  • Mepilex Border lt Allevyn lt Tielle Biatain lt
    Cellosorb lt DuoDERM
  • These data support earlier studies measuring
    stratum corneum damage by the TEWL technique 1.

Fig. 2. 96-well plate for protein measurement of
extracts.
  • References
  • Zillmer R, Ågren MS, Gottrup F, Karlsmark T.
    Biophysical effects of repetitive removal of
    adhesive dressings on peri-ulcer skin. J Wound
    Care 2006 15 187-191.
  • Dreher F, Modjtahedi BS, Modjtahedi SP, Maibach
    HI. Quantification of stratum corneum removal by
    adhesive tape stripping by total protein assay in
    96-well microplates. Skin Res Technol 2005 11
    97-101.

Acknowledgment This work was made possible by a
research grant from Mölnlycke Health Care AB.
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