Cleansing, moisturizing and skin protection in Vascular Surgery

Skin cleansing

Daily skin cleansing, at any age is an important and essential procedure for our own care, since it not only removes dirt or any bacteria from the skin, but also the dead surface skin cells, preparing the skin to better absorb the topical treatments (drugs/creams).
Common problems such as irritation, xerosis, dermatitis, eczema, psoriasis, acne, rosacea, and photodamage, leave the skin vulnerable to external insults mainly due to an alteration of the stratum corneum (SC) skin barrier.
In the daily skin cleansing is therefore important to minimize any further weakening of the stratum corneum barrier, using mild and emollients cleansers, with neutral or acid pH (about pH 5.5) that do not attack or alter this barrier causing dryness, irritation and itching.

Defenses against dehydration

The structure of the skin acts as a barrier essential to maintain hydration of the skin within physiological values. The main factors of this barrier responsible for maintaining hydration are:

  • The Stratum corneum
  • The Epidermal lipids
  • The Natural moisturizing factor (NMF)
  • The hydro-lipid film surface

These components are subjected to a continuous renewal process determined by the ability of the epidermal keratinocytes to reproduce and differentiate continuously, thus giving rise to the various layers of the epidermis.
Different factors, both exogenous and endogenous, may affect these fragile defense mechanisms, causing lower or higher skin dehydration. The extent of skin hydration depends on the humidity, the hygroscopic properties of the stratum corneum and the presence of naturally moisturizing factors, without which you have dry skin. In addition to age and genetic predisposition to skin aging, many external factors can lead to lower or higher skin dehydration. The main factors of dehydration are chemical (eg, the solvent action and loss of skin lipids caused by the continuous use of surfactants) or due to unfavorable climatic or environmental conditions: wind, cold, and humidity, separately or in combination, cause dehydration of the stratum corneum leading to dry, rough, scaly and cracked skin, redness, itching and irritation. Even prolonged contact with water, despite the protection of the sebaceous-sweating film, causes a depletion in NMF. Indeed, a topical application of water alone causes a stress on all the stratum corneum that causes an alteration of its barrier function. The more exposed areas, such as face and hands, are the most affected; however also other areas of the skin are particularly prepared to excessive dryness often associated with a more or less evident flaking skin.

Skin dehydration: Interventions

A dehydrated skin favors the entry of foreign substances, the onset of inflammation and causes loss of elasticity and tone. The application of topical cosmetic formulations on the dehydrated skin is able to restore smoothness, softness and distensibility. Therefore it is necessary to intervene with moisturizing treatments that prevent skin dehydration, and at the same time restoring the optimal content of water and other substances, which may be impaired as a result of multiple factors. Topical treatments are able to intervene on the hydration of the stratum corneum and also to convey compounds able to bring water, and to restructure the skin barrier which is essential to effectively replenish and restore the water and lipid content of the skin (collagen, hyaluronic acid, urea, ceramides, plants lipids and fatty acids treatments). The moisturizing efficacy of a formulation is due not only to the presence of specifically moisturizing ingredients, but also to the choice of vehicle and cosmetic form that contributes to the transfer of such property.

RSS Journal of Vascular Surgery

  • Endovascular Embolization of a Superior Mesenteric Aneurysm in a Patient Without Celiac Trunk: A Case Report April 1, 2023
    Visceral artery aneurysm (VAA) is a rare and critical vascular disease. Aneurysms of the superior mesenteric artery (aSMA) represent 3.2% to 5.5% of all VAA. In addition, 22% of all VAA present as a vascular emergency—either rupture or dissection. Due to the high mortality rate, an increase in open and endovascular procedures has been reported. […]
    Lina M. Sanabria, Romeo Guevara, Camilo A. Polania, Juan G. Barrera
  • Untitled April 1, 2023
    The VEITHsymposium held a successful 2022 Associate Faculty (AF) program, where a record number of national and international abstracts covering various topics in the diagnosis and management of vascular diseases were selected and distributed among 13 different sessions. These sessions were each moderated by three or four well-recognized vascular surgeons/specialists. The moderators actively participated by […]
    Enrico Ascher, Frank J. Veith
  • Vascular e-Learning During the Coronavirus Disease 2019 Pandemic: The EL-COVID Survey April 1, 2023
    The coronavirus disease 2019 pandemic has radically changed the possibilities for vascular surgeons and trainees to exchange knowledge and experience. An exponential growth of medical e-learning activities has produced a significant amount of data. The aim of the present survey is to take inventory of the e-learning needs of vascular surgeons and trainees, as well […]
    Nikolaos Patelis, the EL-COVID Collaborators
  • Three-Year Outcomes of a Single Branch, Off-the-shelf Endovascular Solution for Treating Aortic Arch Pathologies April 1, 2023
    Endovascular aortic arch repair has reduced mortality and paraplegia rates compared to surgery, but current thoracic endovascular aneurysm repair systems still report high stroke rates. Specific features of the NEXUS Aortic Arch Stent Graft System (Endospan, Herzlia, Israel) are designed to help reduce neurological events. This study evaluated this single branch, two-stent graft system specifically […]
    Andrew Holden