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Case #1Children's Hospital, Oakland Children's Hospital of Northern California submitted by Ms. Gail Garvin R.N., M.S., CETN. A 6 year old oncology patient developed intractable diarrhea during a course of chemotherapy. Both his energy level and his mobility were diminished. His appetite was poor but he received optimal calories via parenteral nutrition. Because of limited mobility and frequency of stools he wore diapers. Preventative perianal care was administered using a protective barrier cream and cleansing after each stool with the accompanying wound cleanser spray. The perianal denudation pictured here developed despite using the described intervention for 2-3 weeks. At this time an ET consult was requested. Treatment Results The perianal area was cleansed with a mild antibacterial soap and inspected for signs of an underlying fungal infection. The skin appeared free from fungal invasion. Ilex cream was applied to the denuded skin and covered with a layer of petroleum jelly to prevent sticking to the diaper. After each stool cleansing was done by cleansing the stool while leaving the iLEX cream in tact and reapplying petroleum jelly. No pain was experienced by the patient during the application of the ILEX cream. Photographs document the remarkable improvement in skin integrity at 24 hours and 7-10 days after the initiation of iLEX therapy. |
Case #2Children's Hospital of Philadelphia Pediatric Urology Philadelphia, Pennsylvania submitted by: Nancy Hagelgans, R.N., M.S.N. CETN Clinical Nurse Specialist (currently in private practice; Denver, Colorado) N.B. was born a 25 week preemie and at four weeks developed necrotizing enterocolitis requiring resection of her ileum, her cecum, and her ascending colon. She had an ileostomy for six months and it was then reanastomosed. In June, 1990, she also had a resection of her jejunal-colonic fistula. Her estimated length of remaining small bowel consists of 39.5 cm without her ileocecal valve. Because of her short gut, she has frequent watery stools which have rendered her perineum with severe breakdown for most of her life. A variety of treatments and products were utilized with varying success, but never clearing hert skin at all. At two years of age, she had both epidermal and dermal loss and for many months could not tolerate sitting. Treatment Results On September 19,1991 treatment with iLEX was initiated, according to the manufacturer's suggested application. It is of interst to note that with the first application of the iLex, she had an immediatre change in her personality and was able to sit for the first time in a long time.Her treatments continued and after 12 days of therapy, she had completly resolved. |
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