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      KCI등재 SCOPUS SCIE

      Analgesic effect of structured anal skin care for perianal dermatitis after low anterior resection in the rectal cancer patients: prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial

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      https://www.riss.kr/link?id=A108368964

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      다국어 초록 (Multilingual Abstract)

      Purpose: This prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial aimed to assess the alleviation of anal pain by applying structured anal skin care including skin protectants in rectal cancer patients with low anterior resection syndrome (LARS) combined with anal pain.
      Methods: From December 2017 to May 2020, 42 patients with LARS (scores of ≥21) and anal pain (visual analogue scale [VAS] score of ≥3) were randomly assigned and observed for 4 weeks. The conventional treatment consisted of dietary management, sitz baths, prohibition of anal scrubbing, loperamide, and dioctahedral smectite. In the anal care group, cleanser, barrier cream, and barrier spray were applied to the anal skin after defecation following the conventional treatment. The primary outcome was analgesic effect on anal pain after 2 weeks of structured treatment (anal care group) or conventional (control group). The cutoff for analgesic effect was a decrease in the anal pain score (VAS score of ≥2 or ≥30% reduction).
      Results: As a primary outcome, the analgesic effect was significantly higher in the anal care group (P = 0.034). The incontinence-associated dermatitis skin condition score was significantly improved in the anal care group than control group after 4 weeks (P = 0.023). There were no significant differences in LARS scores and quality of life scores between 2 groups.
      Conclusion: Structured anal skin care has a significant analgesic effect in reducing anal pain and improving anal skin conditions in patients with LARS after rectal cancer surgery.
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      Purpose: This prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial aimed to assess the alleviation of anal pain by applying structured anal skin care including skin protectants in rectal cancer patients with low ...

      Purpose: This prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial aimed to assess the alleviation of anal pain by applying structured anal skin care including skin protectants in rectal cancer patients with low anterior resection syndrome (LARS) combined with anal pain.
      Methods: From December 2017 to May 2020, 42 patients with LARS (scores of ≥21) and anal pain (visual analogue scale [VAS] score of ≥3) were randomly assigned and observed for 4 weeks. The conventional treatment consisted of dietary management, sitz baths, prohibition of anal scrubbing, loperamide, and dioctahedral smectite. In the anal care group, cleanser, barrier cream, and barrier spray were applied to the anal skin after defecation following the conventional treatment. The primary outcome was analgesic effect on anal pain after 2 weeks of structured treatment (anal care group) or conventional (control group). The cutoff for analgesic effect was a decrease in the anal pain score (VAS score of ≥2 or ≥30% reduction).
      Results: As a primary outcome, the analgesic effect was significantly higher in the anal care group (P = 0.034). The incontinence-associated dermatitis skin condition score was significantly improved in the anal care group than control group after 4 weeks (P = 0.023). There were no significant differences in LARS scores and quality of life scores between 2 groups.
      Conclusion: Structured anal skin care has a significant analgesic effect in reducing anal pain and improving anal skin conditions in patients with LARS after rectal cancer surgery.

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      참고문헌 (Reference)

      1 Buzatti KC, "Validation of low anterior resection syndrome score in Brazil with Portuguese" 2022

      2 김창우 ; 정운경 ; 손경모 ; 김익용 ; 박지원 ; 정승용 ; 박규주 ; 이석환, "Validation of Korean Version of Low Anterior Resection Syndrome Score Questionnaire" 대한대장항문학회 36 (36): 83-87, 2020

      3 Lager P, "Use of breathable silicone technology in an ostomy appliance flange" 30 (30): 25-35, 2021

      4 Beeckman D, "Towards an international language for incontinence-associated dermatitis(IAD) : design and evaluation of psychometric properties of the Ghent Global IAD Categorization Tool(GLOBIAD)in 30 countries" 178 : 1331-1340, 2018

      5 유니나 ; 계봉현 ; Kim HyungJin ; Kim Gun ; Cho Hyeon-Min, "The pattern of bowel dysfunction in patients with rectal cancer following the multimodal treatment: anorectal manometric measurements at before and after chemoradiation therapy, and postoperative 1 year" 대한대장항문학회 39 (39): 32-40, 2023

      6 Pather P, "The effectiveness of topical skin products in the treatment and prevention of incontinence-associated dermatitis : a systematic review protocol" 13 : 36-52, 2015

      7 Kaasa S, "The EORTC core quality of life questionnaire(QLQ-C30) : validity and reliability when analysed with patients treated with palliative radiotherapy" 31A : 2260-2263, 1995

      8 Liang LS, "Risk factors associated with low anterior resection syndrome : a cross-sectional study" 2022

      9 Chen Y, "Quality and clinical applicability of recommendations for incontinenceassociated dermatitis : a systematic review of guidelines and consensus statements" 2022

      10 Beeckman D, "Prevention and treatment of incontinence-associated dermatitis : literature review" 65 : 1141-1154, 2009

      1 Buzatti KC, "Validation of low anterior resection syndrome score in Brazil with Portuguese" 2022

      2 김창우 ; 정운경 ; 손경모 ; 김익용 ; 박지원 ; 정승용 ; 박규주 ; 이석환, "Validation of Korean Version of Low Anterior Resection Syndrome Score Questionnaire" 대한대장항문학회 36 (36): 83-87, 2020

      3 Lager P, "Use of breathable silicone technology in an ostomy appliance flange" 30 (30): 25-35, 2021

      4 Beeckman D, "Towards an international language for incontinence-associated dermatitis(IAD) : design and evaluation of psychometric properties of the Ghent Global IAD Categorization Tool(GLOBIAD)in 30 countries" 178 : 1331-1340, 2018

      5 유니나 ; 계봉현 ; Kim HyungJin ; Kim Gun ; Cho Hyeon-Min, "The pattern of bowel dysfunction in patients with rectal cancer following the multimodal treatment: anorectal manometric measurements at before and after chemoradiation therapy, and postoperative 1 year" 대한대장항문학회 39 (39): 32-40, 2023

      6 Pather P, "The effectiveness of topical skin products in the treatment and prevention of incontinence-associated dermatitis : a systematic review protocol" 13 : 36-52, 2015

      7 Kaasa S, "The EORTC core quality of life questionnaire(QLQ-C30) : validity and reliability when analysed with patients treated with palliative radiotherapy" 31A : 2260-2263, 1995

      8 Liang LS, "Risk factors associated with low anterior resection syndrome : a cross-sectional study" 2022

      9 Chen Y, "Quality and clinical applicability of recommendations for incontinenceassociated dermatitis : a systematic review of guidelines and consensus statements" 2022

      10 Beeckman D, "Prevention and treatment of incontinence-associated dermatitis : literature review" 65 : 1141-1154, 2009

      11 Voegeli D, "Prevention and management of moisture-associated skin damage" 30 : S40-S46, 2021

      12 Pieniowski EH, "Prevalence of low anterior resection syndrome and impact on quality of life after rectal cancer surgery : populationbased study" 4 : 935-942, 2020

      13 Chris George Cura Pales ; 안상현 ; Jan Paolo Cruz ; 김광민 ; 김영완, "Postoperative Bowel Function After Anal Sphincter-Preserving Rectal Cancer Surgery: Risks Factors, Diagnostic Modalities, and Management" 대한대장항문학회 35 (35): 160-166, 2019

      14 Joost A.G. van der Heijden ; Kelly G.H. van de Pas ; Frank J.C. van den Broek ; Francois M.H. van Dielen ; Gerrit D. Slooter ; Adriana J.G. Maaskant-Braat, "Oncological and functional outcomes of transanal total mesorectal excision in a teaching hospital in the Netherlands" 대한대장항문학회 38 (38): 28-35, 2022

      15 McNichol L, "Moistureassociated skin damage : expanding practice based on the newest ICD-10-CM codes for irritant contact dermatitis associated with digestive secretions and fecal or urinary effluent from an abdominal stoma or enterocutaneous fistula" 49 : 235-239, 2022

      16 Gray M, "Moistureassociated skin damage : expanding and updating practice based on the newest ICD-10-CM codes" 49 : 143-151, 2022

      17 Parnham A, "Moistureassociated skin damage : causes and an overview of assessment, classification and management" 29 : S30-S37, 2020

      18 Budri AM, "Moisture-associated skin damage : a framework to guide decision making" 31 : S4-S6, 2022

      19 Feng J, "Management of intractable pain in patients treated with hemorrhoidectomy for mixed hemorrhoids" 10 : 479-483, 2021

      20 Christensen P, "Management guidelines for low anterior resection syndrome : the MANUEL project" 23 : 461-475, 2021

      21 RidolfiTJ, "Low anterior resection syndrome : current management and future directions" 29 : 239-245, 2016

      22 Dulskas A, "Long-term bowel dysfunction following low anterior resection" 10 : 11882-, 2020

      23 Beeckman D, "Incontinence-associated dermatitis : stepby-step prevention and treatment" 16 : 382-389, 2011

      24 Langemo D, "Incontinence and incontinence-associated dermatitis" 24 : 126-140, 2011

      25 Elroy Patrick Weledji, "Electrophysiological Basis of Fecal Incontinence and Its Implications for Treatment" 대한대장항문학회 33 (33): 161-168, 2017

      26 Kyung Ha Lee ; Jin Soo Kim ; Ji Yeon Kim, "Efficacy of biofeedback therapy for objective improvement of pelvic function in low anterior resection syndrome" 대한외과학회 97 (97): 194-201, 2019

      27 Park KH, "Effect of a structured skin care regimen on patients with fecal incontinence : a comparison cohort study" 41 : 161-167, 2014

      28 Ryun Kyong Ha ; Sung Chan Park ; 박보람 ; Sung Sil Park ; Dae Kyung Sohn ; Hee Jin Chang ; Jae Hwan Oh, "Comparison of patient-reported quality of life and functional outcomes following laparoscopic and transanal total mesorectal excision of rectal cancer" 대한외과학회 101 (101): 1-12, 2021

      29 Warshaw E, "Clinical and cost effectiveness of a cleanser protectant lotion for treatment of perineal skin breakdown in low-risk patients with incontinence" 48 : 44-51, 2002

      30 Beeckman D, "A decade of research on incontinence-associated dermatitis(IAD) : evidence, knowledge gaps and next steps" 26 : 47-56, 2017

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