CU College of Nursing’s Noreen Heer Nicol, PhD, RN, FNP, recently published results of a study on the benefits of supervised Wet Wrap Therapy (WWT) as an acute intervention in improving atopic dermatitis severity. Atopic dermatitis (AD) is the most common chronic, relapsing inflammatory skin disease among children.
Results of Nicol’s work with National Jewish Health colleagues Mark Boguniewicz, MD; Matthew Strand, PhD; and Mary D. Klinnert, PhD, were published in an article, “Wet Wrap Therapy in Children with Moderate to Severe Atopic Dermatitis in a Multidisciplinary Treatment Program,” in The Journal of Allergy and Clinical Immunology: In Practice.
Nicol presented this work at the American College of Allergy, Asthma and Immunology 2014 Annual Scientific Meeting in Atlanta on Nov. 9.
Their study included 72 children, ages 6 months to 12.8 years, who have been diagnosed with acute moderate-to-severe atopic dermatitis. Each had been treated previously with multiple therapeutic interventions that had failed.
For the study, the participants were given a 10- to 15-minute bath in warm tap water, and as needed, a gentle cleansing bar or wash, formulated for sensitive skin was used. The bath was followed immediately by application of a topical medication to their lesions and moisturizers to the clear areas.
Depending on the severity of the lesions, the patients were prescribed two or three supervised baths per day, with each bath followed by topical medications or moisturizer applications and WWT using children’s normal cotton-blend clothing. The only area treated with gauze or dressings was the face. Wet wraps were left in place a minimum of two hours and, generally, removed after four to six hours, although they could be left on overnight if the patient fell asleep with wet wraps in place.
The researchers found that the WWT allowed these patients’ symptoms to be managed without systemic immunosuppressive therapy, and they then were able to transition off of WWT before discharge from the program study. In follow-up, these patients maintained improvement one month after discharge.
Nicol was the former chief nursing officer/clinical officer at National Jewish Health and had worked with the multidisciplinary team in the Atopic Dermatitis Program for more than 23 years. She was one of the first to describe the use of WWT to treat atopic dermatitis in children in the American Journal of Nursing in 1987. This work was done to highlight the important role of daily basic skin care and conventional topical therapies in the treatment of this common, chronic inflammatory skin disease.