Ions of structure X[N(O)NO]- display broad-spectrum pharmacological activity that correlates with the rate and extent of their spontaneous, first-order decomposition to nitric oxide when dissolved. We report incorporation of this functional group into polymeric matrices that can be used for altering the time course of nitric oxide release and/or targeting it to tissues with which the polymers are in physical contact. Structural types prepared include those in which the [N(O)NO]- group is attached to heteroatoms in low molecular weight species that are noncovalently distributed throughout the polymeric matrix, in groupings pendant to the polymer backbone, and in the polymer backbone itself. They range in physical form from films that can be coated onto other surfaces to microspheres, gels, powders, and moldable resins. Chemiluminescence measurements confirm that polymers to which the [N(O)NO]- group is attached can serve as localized sources of nitric oxide, with one prototype providing sustained NO release for 5 weeks in pH 7.4 buffer at 37 degrees C. The latter composition, a cross-linked poly-(ethylenimine) that had been exposed to NO, inhibited the in vitro proliferation of rat aorta smooth muscle cells when added as a powder to the culture medium and showed potent antiplatelet activity when coated on a normally thrombogenic vascular graft situated in an arteriovenous shunt in a baboon's circulatory system. The results suggest that polymers containing the [N(O)NO]- functional group may hold considerable promise for a variety of biomedical applications in which local delivery of NO is desired.

BACKGROUND:Protecting the skin against moisture-associated damage is an important component of comprehensive skin and wound care. Based on a review of literature, the authors propose key interventions to protect and prevent damage in the skin folds, perineum, and areas surrounding a wound or stoma.OBJECTIVE:The aim of this scoping review is to identify and provide a narrative integration of the existing evidence related to the management and prevention of moisture-associated skin damage (MASD).METHODS:Study authors searched several databases for a broad spectrum of published and unpublished studies in English, published between 2000 and July 2015. Selected study information was collated in several different formats; ultimately, key findings were aggregated into a thematic description of the evidence to help generate a set of summative statements or recommendations.RESULTS:Based on inclusion criteria, 37 articles were considered appropriate for this review. Findings included functional definitions and prevalence rates of the 4 types of MASD, assessment scales for each, and 7 evidence-based strategies for the management of MASD.CONCLUSIONS:Based on this scoping review of literature, the authors propose key interventions to protect and prevent MASD including the use of barrier ointments, liquid polymers, and cyanoacrylates to create a protective layer that simultaneously maintains hydration levels while blocking external moisture and irritants.

The NBSC had a lower projected cost for prevention of skin tears and more skin-tear-free days when compared with non-NBSC products.

Residues from hydrocolloid dressings (HCDs) that originate from matrix disintegration and nonbiodegradability of the absorbent components, may cause deep-seated, unresolved inflammation in tissue that appears otherwise healed. The purpose of this study was to evaluate three new HCDs that were formulated with the goal of attenuating the inflammatory responses that may arise from HCD therapy. Two of the HCDs (A-106 and A-107) consisted of conventional absorbents dispersed in a new maceration-resistant adhesive matrix. The same matrix, mixed with potentially biodegradable dextran microspheres, formed the third dressing (Dextran Bead Dressing [DBD]). In this pilot scale study these novel dressings were evaluated on full-thickness dermal wounds on swine. Restore (Hollister) and DuoDERM CGF (Convatec) dressings were used as controls. Wound healing was evaluated histomorphometrically. Pertinent histologic parameters were ranked from wound tissue that was harvested 18 days after wounding. Grossly visible dressing disintegration ranged from minimal (DBD) to severe (Restore). Disintegration of other dressings was moderate. The percentage of tissue sections exhibiting giant cells reflected, in parallel, the observed extent of dressing disintegration. Thirty-eight percent of wounds dressed with DBD contained giant cells; 74 and 100% of wounds treated with DuoDERM CGF and Restore, respectively, contained giant cells. DBD-dressed wounds had relatively fewer chronic inflammatory cells than other dressings. These wounds were also characterized by a well-organized collagen matrix and complete reepithelialization. The extent of wound closures was similar for all dressing types except Restore. Closure of Restore-dressed wounds was delayed compared with closure with DBD and DuoDERM CGF on all days of evaluation except one. A-106 and A-107 were comparable to DuoDERM CGF in retention of dressing integrity and the elicited inflammatory tissue response. The DBD dressing appears to possess equivalent properties of typical HCDs while causing minimal tissue reactions.

INTRODUCTION: Skin fissures are a common dermatologic condition caused by excessive dry skin, numerous systemic diseases, and backless shoe gear. They are defects in skin that fall into the category of damaged, partial-thickness skin wounds, as opposed to full-thickness wounds. Patients with heel fissures are at an increased risk for developing infection, which could cause more severe issues, especially in patients with diabetes and peripheral vascular disease.METHODS: Five patients from Temple Foot and Ankle Institute, Philadelphia, PA, with a total of 8 heel fissures and 2 hallux fissures, were studied. Patients were dispensed 9 vials of a cyanoacrylate liquid skin protectant (Marathon Ô , Medline Industries, Inc, Mundelein, IL) to be applied to the fissure every 3 days. Patients returned every 2 weeks for follow-up in clinic.RESULTS: The hallux fissures and 4 of the heel fissures went to complete closure after 2 weeks. There was an average decrease of 1.16 cm in length of the heel fissure dimensions after 2 weeks and an average decrease of 1.1 cm in length of the hallux fissures.CONCLUSION: This novel skin protectant proved to be a comfortable, easy, and effective tool in aiding the resolution of pedal skin fissures.

The use of an SBDNE skin care regimen was important in bringing about a significant reduction in the number of patients with PrUs and respective treatment costs in a medical unit experiencing high incidence rates of PrUs.

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PUPP assisted in reducing the incidence of PrUs by 67% in a 6-month period in nursing home facilities. The estimated annual net cost savings attributed to PUPP for 300 MVH residents is estimated at approximately $240,000.