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Protease Enzyme Inhibitor Cream for the Prevention of Diaper Dermatitis After Gastrointestinal Surgery in Children:

Demi Huijgen1, Irene K Schokker-van Linschoten1, Hendt P Versteegh1

  • 1Department of Pediatric Surgery, Erasmus University Medical Center, Sophia Children's Hospital, 3015 GD Rotterdam, The Netherlands.

Children (Basel, Switzerland)
|August 28, 2025
PubMed

Insights

Diaper dermatitis (DD) affects over 70% of children after gastrointestinal surgery, even with preventive creams like potato-derived protease enzyme inhibitor cream (PPEIC) or Panthenol cream (PC). Neither cream proved superior in this study.

Area of Science:

  • Pediatric Surgery
  • Dermatology
  • Clinical Research

Background:

  • Diaper dermatitis (DD) is a common complication following pediatric gastrointestinal surgery.
  • Preventive measures are often insufficient, leading to significant patient morbidity.

Purpose of the Study:

  • To evaluate the efficacy of potato-derived protease enzyme inhibitor cream (PPEIC) in preventing DD in children post-gastrointestinal surgery.
  • To compare PPEIC with Panthenol cream (PC) as a preventive measure.

Main Methods:

  • A double-blinded, single-center randomized controlled trial (RCT) involving 30 pediatric patients under three years old.
  • Patients received either PPEIC or PC applied after each diaper change for four weeks post-surgery.
  • DD presence and severity were assessed via photographic evaluation at two and four weeks.

Main Results:

  • A high incidence of DD (73.1%) was observed in both groups, with no statistically significant difference between PPEIC (66.7%) and PC (78.6%).
  • Severe DD occurred in 63.2% of affected patients, primarily within the first two weeks post-surgery.
  • Nearly half of the participants discontinued their assigned preventive cream before the four-week study endpoint.

Conclusions:

  • Diaper dermatitis remains a significant challenge in pediatric patients undergoing gastrointestinal surgery, despite current preventive strategies.
  • The study did not identify a superior preventive cream between PPEIC and PC.
  • Further research is warranted to develop more effective interventions for preventing DD in this vulnerable population.

Keywords:
dermatitisdiaper rashgastrointestinal surgerypreventionprotease inhibitors

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