1199 TRANSEPIDERMAL EVAPORATIVE WATER LOSS OF PREMATURE INFANTS: EFFECTS OF SKIN COVER WITH PARAFFIN OR A TRANSPARENT ADHESIVE POLYURETHANE FILM

Abstract

Transepidermal evaporative water loss (TEWL) of premature infants is a significant problem affecting temperature regulation and fluid balance. High relative humidity and covers of various types have been used to reduce TEWL. Using a recently developed evaporimeter we measured TEWL in premature infants simltaneously treated with high humidity, a paraffin ointment (PAR) or a transparent adhesive polyurethane film (TAP). The ten subjects were included in the study after parental consent, had a mean birth weight of 1652.50 gm (± 89.73; SEM) and gestation of 33.6 weeks (± 0.5; SEM), were cared for in incubators with servo-control of the temperature and entered the study at a mean age of 3.2 days (± 0.9; SEM). The relative humidity of the environment at the site of TEWL measures was 65.77% (± 4.17; SEM). Each infant had one leg covered with PAR (70% solid and 30% liquid paraffin); the other leg was covered with TAP and the buttock area served as the control surface. TEWL measures were made once a day for four consecutive days with minimal disturbance of the subject. Each set of measures was combined to a mean TEWL per site per subject and then analyzed for statistical differences. The mean TEWL of the control was 3.78 gm of water per M2 per hour (± 0.30; SEM), for the TAP group was 1.90 (± 0.26) and for the PAR group 3.03 (± 0.28). TAP is significantly better than PAR (P <0.01) and high relative humidity alone (P <0.01) to reduce TEWL.