Jan Kottner

• Professor
• Charité Universitätsmedizin Berlin

Skin tears are traumatic wounds and are among the most prevalent skin conditions in older adults, particularly those in long-term care facilities. These injuries can lead to complications such as infection, pain, reduced quality of life, and increased healthcare costs. This study aimed to identify risk factors for skin tear development in nursing h...

Aim: The European Pressure Ulcer Advisory Panel, the National Pressure Injury Advisory Panel and the Pan Pacific Pressure Injury Alliance (EPUAP/NPIAP/PPPIA) collaboratively developed International Clinical Practice Guidelines for the prevention and treatment of pressure ulcers/injuries in 2009, 2014, and 2019. Dissemination of these guidelines inv...

Regular use of leave-on skin care products has positive effects on the skin barrier and appears to influence the skin microbiome in atopic dermatitis (AD). However, product-related effects on the skin microbiome are unclear. The aim of this study was to investigate to which extent the application of an emollient plus product differs from a petrolat...

Preventing pressure injuries (PIs) remains the most effective way to reduce their burden. A key element of prevention is the assessment of PI risk. The study aimed to investigate whether guidance documents relevant to the United States (US) advocated for specific risk assessment recommendations. We conducted a systematic review of guidance document...

Wound infections are still an interdisciplinary and interprofessional challenge, because of numerous complications, particularly in people with chronic wounds. There are many different concepts and approaches in this field today. Therefore, WundDACH, the umbrella organization of the German-speaking wound healing societies, wrote a position paper on...

Pressure ulcers (PUs) or pressure injuries are severe unwanted skin and soft tissue lesions and wounds associated with severe illness, invasive treatments, and/or care dependency. Although there is wide agreement, that not all PUs can be prevented, empirical evidence indicates that appropriately and timely implemented interventions are very effecti...

Introduction Incontinence is commonly experienced by adults who receive care support in a residential facility or in their own home. These individuals are at risk of developing incontinence‐associated dermatitis (IAD), which is caused by prolonged and repeated exposure of the skin to urine or faeces. An IAD manual was developed providing an evidenc...

Objectives Medical adhesives provide securement of medical devices, facilitate skin protection and allow non-invasive monitoring. Application and removal of medical adhesives can result in pain, dermatitis, trauma or other skin lesions. Understanding patients’ experiences when subjected to medical adhesives will contribute to the improvement of cli...

Introduction: Delirium is one of the most common forms of acute cerebral dysfunction in critically ill children, leading to increased morbidity and mortality. The aim was to identify studies describing or evaluating non-pharmacological interventions to prevent or treat pediatric delirium. Methods: Scoping Review Searches were performed in Medline,...

In clinical practice, a large variety of medical devices adhere to skin to perform their function. The repeated application and removal of these devices can lead to skin damage or medical adhesive-related skin injury. Awareness of this problem has increased in the past decade, and this adverse event can be prevented with appropriate selection of ad...

The European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific Pressure Injury Alliance collaboratively developed three editions of the International Clinical Practice Guidelines for preventing and treating pressure ulcers/injuries in 2009, 2014, and 2019. Dissemination and uptake of these guidelines are import...

Incontinence‐associated dermatitis (IAD) is an irritant contact dermatitis from prolonged contact with urine or faeces, which can significantly impact patient comfort and quality of life. The identification of prognostic factors for the development of IAD has the potential to enhance management, support preventive measures and guide future research...

A close and strong connection between the dermis and the epidermis is crucial for the skin to function properly. A decreased strength of the dermoepidermal adhesion may lead to cutaneous fragility, lesions, and wounds. Suction blisters develop, when a prolonged constant negative pressure is applied on a defined area of the skin surface. During cont...

Prolonged mechanical loading of the skin and underlying soft tissue cause pressure ulceration. The use of special support surfaces are key interventions in pressure ulcer prevention. They modify the degree and duration of soft tissue deformation and have an impact on the skin microclimate. The objective of this randomized cross‐over trial was to co...

The COSEB initiative aims for standardized and uniform measurement by developing core outcome sets for epidermolysis bullosa. This report describes the COSEB workshop organized in December 2023, which led to a broad stakeholder consensus-based roadmap. Moreover, it highlights novel features of COSEB, including the pro-active engagement of stakehold...

The population of older people is steadily increasing and the majority live at home. Although the home and community are the largest care settings worldwide, most of the evidence on dermatological care relates to secondary and tertiary care. The overall aims were to map the available evidence regarding the epidemiology and burden of the most freque...

Neurosciences clinical trials continue to have notoriously high failure rates. Appropriate outcomes selection in early clinical trials is key to maximizing the likelihood of identifying new treatments in psychiatry and neurology. The field lacks good standards for designing outcome strategies, therefore The Outcomes Research Group was formed to dev...

Neurosciences clinical trials continue to have notoriously high failure rates. Appropriate outcomes selection in early clinical trials is key to maximizing the likelihood of identifying new treatments in psychiatry and neurology. The field lacks good standards for designing outcome strategies, therefore The Outcomes Research Group was formed to dev...

Pressure ulcers are defects of the skin and/or underlying tissues that occur because of pressure or pressure in combination with shear. Pressure ulcers occur due to prolonged exposure to mechanical load that increases internal stresses and strains. Some individuals are at increased risk of developing a pressure ulcer, particularly those who are imm...

Background and Aims Skin aging is associated with dry skin and a decrease of the strength of the dermoepidermal adhesion, which increases the risk for lacerations (skin tears). Application of leave‐on products improves dry skin and seems to reduce skin tear incidence. The aim of this study was to measure the effects of a humectant containing leave‐...

Incontinence and toileting difficulties can often be successfully addressed by treating their underlying causes. However, (complete) cure is not always possible and continence products to prevent or contain unresolved leakage or to facilitate toileting are in widespread use. Many people use them successfully but identifying the product(s) most like...

Introduction Core outcome sets (COSs) are agreed outcomes (domains (subdomains) and instruments) that should be measured as a minimum in clinical trials or practice in certain diseases or clinical fields. Worldwide, the number of COSs is increasing and there might be conceptual overlaps of domains (subdomains) and instruments within disciplines. Th...

Background Core outcome sets (COS) represent agreed-upon sets of outcomes, which are the minimum that should be measured and reported in all trials in specific health areas. Use of COS can reduce outcome heterogeneity, selective outcome reporting, and research waste, and can facilitate evidence syntheses. Despite benefits of using COS, current use...

Objectives The National Pressure Injury Advisory Panel, European Pressure Ulcer Advisory Panel and the Pan Pacific Pressure Injury Alliance are commencing a new (fourth) edition of Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline . The aim is to outline the methodology. Methods The fourth edition of the Internation...

This approach can be applied to cover the unmet needs of specific conditions in which the guidance will be a helpful aid to COA selection for clinical trials. The guide contains recommendations and case examples. (Scan QR Code to Download the Guide) https://qrco.de/bcN9Bt

Introduction: Delirium is one of the most common forms of acute cerebral dysfunction in critically ill children leading to increased morbidity and mortality. Prevention, identification and management of delirium is an important part of paediatric and neonatological intensive care. This scoping review aims to identify and map evidence on non-pharmac...

Pressure ulcer/injury (PU) risk assessment is widely considered an essential component in clinical practice. It is a complex and broad concept that includes different approaches, such as clinical judgement, using standardised risk assessment instruments, skin assessments, or using devices to measure skin or tissue properties. A distinction between...

Objectives: The purpose of this review was to identify prognostic models for clinical application in patients with venous leg ulcers (VLUs). Study design and setting: Literature searches were conducted in Embase, Medline, Cochrane and CINAHL databases from inception to 22nd December 2021. Eligible studies reported prognostic models aimed at deve...

Introduction Incontinence-associated dermatitis (IAD) is irritant contact dermatitis and skin damage associated with prolonged skin contact with urine and/or faeces. Identifying prognostic factors for the development of IAD may improve management, facilitate prevention and inform future research. Methods and analysis This protocol follows the guid...

Introduction Medical adhesives are adhesives used in medical devices to establish and maintain contact with the body over a period of time (usually by application to the skin) and are widely used in most care settings. Application of medical adhesives to the skin can lead to skin stripping, mild or severe allergic reactions and skin irritation that...

Introduction Ageing is accompanied by an age-related decrease in mobility or cognitive and sensory functions; in addition, physiological changes in the skin occur with age. Therefore, the skin requires appropriate care and observation in order to prevent or manage a variety of dermatological diseases and conditions, and to prevent or minimise effec...

Aim: The aim of this study was to summarize and evaluate the empirical evidence on the measurement properties of diaper dermatitis (DD) measurement instruments in children. Design: Systematic review. Methods: MEDLINE, CINAHL and EMBASE were systematically searched until 14 June 2021. Citation searching was conducted in Scopus. The risk of bias...

The European Pressure Ulcer Advisory Panel, the National Pressure Injury Advisory Panel and the Pan Pacific Pressure Injury Alliance developed international Clinical Practice Guidelines of the prevention and treatment of pressure ulcers/injuries in 2009, 2014, and 2019. Despite substantial dissemination efforts, evidence about guideline disseminati...

Background: Epidermolysis bullosa (EB) is a rare, genetically and clinically heterogenous group of skin fragility disorders. No cure is available yet, but many novel and repurposed treatments are underway. For adequate evaluation and comparison of clinical studies in EB, well-defined and consistent consensus-endorsed outcomes and outcome measureme...

Background: Daily skin care routines are fundamental aspects of clinical nursing practice. Providing skin care, including skin cleansing and application of leave-on products have substantial impact on the prevention and treatment of a number of skin conditions. There are hundreds of individual studies about skin risks, classifications, skin condit...

Background Skin care is a basic, daily activity performed by formal and informal caregivers from birth until end of life. Skin care activities are influenced by different factors as e.g., culture, knowledge, industrial developments and marketing activities. Therefore, various preferences, traditions and behaviours exist worldwide including skin car...

Background: The number of elderly and care-dependent people is increasing, leading to increased risks of adverse skin conditions. Skin care, including prevention and treatment of vulnerable skin, is an essential part of daily nursing practice in long-term residential settings. For many years, the research focus has been on individual skin problems...

Background Lichen sclerosus (LS) is a chronic inflammatory condition mainly affecting genital skin. It causes distressing symptoms that impact daily quality of life (QoL). It causes progressive anatomical changes and a potential risk of cancer. Published randomised controlled trials are of varying methodological quality and difficult to combine in...

Alopecia areata (AA) is an autoimmune‐mediated non‐scarring hair loss whose stigmatizing effect may have severe psychosocial impact. AA has been reported to be correlated with bullying, reduced quality of life (QoL) and psychiatric comorbidities. The effect of AA on QoL in adult patients has been systematically reviewed and found to be detrimental....

The International Wound Dressing Technology Expert Panel has provided important work about the history of wound treatment dressing construction, development and testing methods related to clinical performance. As it now stands, these types of dressings require additional rigorous engineering testing to ensure that the indication of a dressing, whet...

Objective After launching the 2019 International Pressure Ulcer/Injury Guideline, the National Pressure Injury Advisory Panel (NPIAP), the European Pressure Ulcer Advisory Panel (EPUAP) and the Pan Pacific Pressure Injury Alliance (PPPIA) collaborated with Sensorydata Corp., US, to develop a guideline app (InterPIP App). The app was designed to: pr...

Background: It has been proposed that regular emollient application in early life could enhance skin barrier function and prevent atopic dermatitis (AD) especially in predisposed infants. This hypothesis was supported by evidence from exploratory and pilot trials showing protective effects in terms of reduced cumulative atopic dermatitis incidence...

Introduction Entrustable professional activities were introduced in medical education more than 15 years ago. EPAs define units of professional practice that can be fully entrusted to sufficiently competent professionals. Today, EPAs have been developed and implemented in many health professions, as the concept is useful in bridging the gap between...

Introduction The majority of aged long-term care receivers and patients in geriatric acute care are affected by some form of incontinence. These individuals are at risk of developing incontinence-associated dermatitis (IAD), a common type of irritant contact dermatitis caused by repeated and prolonged direct contact of the skin with urine and stool...

The majority of aged long-term care receivers and patients in geriatric acute care are affected by some form of incontinence. These individuals are at risk of developing incontinence-associated dermatitis (IAD), a common type of irritant contact dermatitis caused by repeated and prolonged direct contact of the skin with urine and stool. The prevale...

Hintergrund/Fragestellung Die adäquate Durchführung evidenzbasierter Körperpflege bei älteren pflegebedürftigen Menschen kann dazu beitragen, häufige altersassoziierte Hauterkrankungen zu vermeiden. Um professionell Pflegende bei der Wahl am besten geeigneter Hautpflegeprodukte und -techniken zu unterstützen, wurde ein evidenzbasiertes Hautpflegepr...

Background The European Pressure Ulcer Advisory Panel, the National Pressure Injury Advisory Panel and the Pan Pacific Pressure Injury Alliance developed international Clinical Practice Guidelines of the prevention and treatment of pressure ulcers/injuries in 2009, 2014, and 2019. Despite substantial dissemination efforts, evidence about guideline...

Linked Article: Langbroek et al. Br J Dermatol 2022; 187:730–742.

Background: There is substantial heterogeneity between trial outcomes in pressure ulcer prevention research. The development of core outcome sets (COS) is one strategy to improve comparability between trial results and thus increase the quality of evidence. Objectives: The aim of this study was to identify core outcomes for pressure ulcer preven...

Zusammenfassung. Hintergrund: Die Unterstützung bei der Körperpflege gehört zu den Kernaufgaben der Pflege. Verschiedene Faktoren können die Umsetzung evidenzbasierter Pflege beeinflussen. Ziel: Die Untersuchung von Sichtweisen beruflich Pflegender in der stationären Langzeitpflege zur Bedeutung und zur Begründung pflegerischer Maßnahmen in der Unt...

Several skin diseases are characterised by epidermal alterations affecting epidermal thickness. Reference values of epidermal thickness in healthy humans and knowledge of possible differences regarding age, sex, skin phototype, and ethnic origin are essential in research and in clinical practice. The objectives of this systematic review were to pro...

Background: Core outcome sets (COS) represent agreed-upon sets of outcomes, which are the minimum that should be measured and reported in all trials in specific health areas. Use of COS can reduce outcome heterogeneity, selective outcome reporting, and research waste, and can facilitate evidence syntheses. Despite benefits of using COS, current use...

Zusammenfassung Patienten mit chronischen Wunden werden heute in vielen unterschiedlichen Bereichen der Medizin behandelt. Trotz dieser großen interdisziplinären und interprofessionellen Bedeutung, fehlt es weiterhin an einheitlich akzeptierten Definitionen und Einteilungen. Eine Expertengruppe der Fachgesellschaft Initiative Chronische Wunden (ICW...

Aim of the study: Mechanical loading causes skin occlusion and deformation, which influences structural and functional skin properties. Aims of the study were to measure structural and functional skin parameters after loading at the sacral and heel skin and to describe possible associations. Material and methods A secondary data analysis based on...

Background Xerosis cutis or dry skin is a highly prevalent dermatological disorder especially in the elderly and in patients with underlying health conditions. In the past decades, numerous molecular markers have been investigated for their association with the occurrence or severity of skin dryness. The aim of this review was to summarize the mole...

Background. Pregnancy leads to several skin changes, but evidence about structural and functional skin changes is scarce. Findings on skin structure and function in children in their first year reveal rapid skin maturation, but evidence indicates that in particular, water holding and transport mechanisms are different from adults. Important questio...

The urgent need to find treatments for a large number of degenerative diseases has led a group of experts to develop a manual designed to accelerate new discoveries in therapies in neurological and psychiatric diseases. Project leads are, Dra Silvia Zaragoza Domingo as consultant and fundar of the company Neuropsynchro fron Barcelona as coordinator...

Objectives To examine current practices in late-phase trials published in major medical journals and examine trialists’ views about core outcome set (COS) use. Design and Setting A sequential multi-methods study was conducted. We examined late-phase trials published between October 2019 and March 2020 in JAMA, NEJM, The Lancet, BMJ, and Annals of...

Background Consumer engagement is a requirement of high quality clinical guidelines. Developing strategies to engage consumers and incorporate the perspectives of individuals with or at risk of pressure ulcers/injuries and their informal caregivers was one priority in the recent update of the EPUAP/NPIAP/PPPIA's Prevention and Treatment of Pressure...

In 2019, the third and updated edition of the Clinical Practice Guideline (CPG) on Prevention and Treatment of Pressure Ulcers/Injuries has been published. In addition to this most up-to-date evidence-based guidance for clinicians, related topics such as pressure ulcers (PUs)/pressure injuries (PIs) aetiology, classification, and future research ne...

Skin ageing is associated with various structural alterations including a decreased strength of the dermo‐epidermal adhesion increasing the risk for shear type injuries (skin tears). Topical applications of basic skin care products seem to reduce skin tear incidence. The suction blister method leads to the artificial and controlled separation of de...

Zusammenfassung Wund-D.A.CH. hat sich als Dachverband deutschsprachiger Wundbehandlungs-Fachgesellschaften in dieser Best Practice Empfehlung mit Flüssigkeits-assoziierten Hautschäden (FAH) befasst, die im englischsprachigen Raum als moisture-associated skin damage (MASD) bezeichnet werden. In diesem Expertenkonsens werden die Krankheitsbilder Inko...

Background and objectives: Gene mutations within the leptin-melanocortin signaling pathway lead to severe early-onset obesity. Recently, a phase 2 trial evaluated new pharmacological treatment options with the MC4R agonist setmelanotide in patients with mutations in the genes encoding proopiomelanocortin (POMC) and leptin receptor (LEPR). During t...

Wund‐D.A.CH., as the umbrella organization of German‐speaking wound treatment societies, has currently developed a best practice recommendation for skin damage caused by body fluids, which is known as moisture‐associated skin damage (MASD) in English‐speaking countries. In this expert consensus, the diseases incontinence‐associated dermatitis (IAD)...

Pressure ulcers/injuries are caused by sustained loading and deformation of skin and underlying soft tissues. Prophylactic dressings are recommended as an adjunct to other preventive measures such as repositioning and offloading. The aim of this study was to investigate the effects of prophylactic soft silicone multi‐layered foam dressings on the s...

Linked Article: van Zuuren et al. Br J Dermatol 2021; 185:36–51.

In skin and wound research the instrumental measurement of skin function is established. Despite the widespread use, empirical evidence about measurement errors is widely lacking. The aim of this study was to measure reliability and agreement of skin temperature, transepidermal water loss, epidermal hydration, and erythema at the heel and sacral sk...