TOPICAL OINTMENT THERAPY BENEFITS PREMATURE-INFANTS

Objective: Premature infants have an ineffective epidermal barrier, Th e aim of this study was to investigate the cutaneous and systemic effe cts of preservative-free topical ointment therapy in premature infants . Study design: We conducted a prospective, randomized study of 60 inf ants less than 33 weeks' estimated gestational age, The treated infant s received therapy for 2 weeks with twice-daily preservative-free topi cal ointment therapy while the control group received no topical treat ment or as-needed therapy with a water-in-oil emollient, Data collecti on included transepidermal water loss (TEWL) measurement, skin conditi on evaluations, fungal and quantitative bacterial skin cultures, analy sis of fluid requirements, patterns of weight loss or gain, and the in cidence of blood and cerebrospinal fluid cultures positive for microor ganisms. Results: We found that topical ointment therapy significantly decreased TEWL during the first 6 hours after the initial application . TEWL was decreased by 67% (p = 0.0001) when measured 30 minutes afte r application and 34% (p = 0.001) when measured 4 to 6 hours after app lication, We also observed significantly superior skin condition score s in the treated group on study days 7 and 14 (p = 0.001 and 0.0004, r espectively), Quantitative bacterial cultures revealed significantly l ess colonization of the axilla on day 2, 3, or 4 and on day 14 (p = 0. 008 and 0.04, respectively), The incidence of positive findings in blo od and/or cerebrospinal fluid cultures was 3.3% in the treated group o f infants versus 26.7% in the control group (P = 0.02). There was no s tatistical difference in the fluid requirements or patterns of weight gain or loss during the 2 weeks of the study. Conclusions: Preservativ e-free topical ointment therapy decreased TEWL for 6 hours after appli cation, decreased the severity of dermatitis, and decreased bacterial colonization of axillary skin, Infants treated with ointment had fewer blood and cerebrospinal fluid cultures positive for microorganisms, T hese data support the use of topical ointment therapy in very prematur e infants during the first weeks after birth.