White Petrolatum and Olivamine™ for a Complex Patient With Perineal Dermatitis: An Enigma

Case: An 87 year old morbidly obese patient with dementia has a long history of poorly healed recurrent perineal dermatitis secondary to bowel and bladder incontinence and sacral decubitus ulcers from persistent immobility. In addition, she has a history of diabetes mellitus, hypertension, renal failure, arthritis and congestive heart failure. She presented from her skilled nursing facility with a new partial thickness wound measuring 2.0 x 0.2 cm² on the buttock region of unknown duration, with an open edge and complete dermal layer involvement. The periwound skin had hyperpigmentation and epithelial scarring. In place of the typical petrolatum barrier application, the wound was cleansed with benzalkonium chloride/olivamine™ and a protective layer of white petrolatum/olivamine™ was applied twice a day. Patient was also placed on an air mattress. There was a complete wound closure within 6 days of therapy, a healing rate faster than any of her previous episodes of perineal dermatitis.  

Discussion: For the treatment of perineal dermatitis, a combination of white petrolatum and olivamine™ barrier ointmentmay have a superior effect compared to other products currently available on the market. The white petrolatum shields the skin from excessive moisture and decreases shear stress while olivamine™ contains antioxidants, amino acids and vitamins, all of which are important for collagen formation and protection. Despite the fact that our patient presented with multiple factors that delay healing of a perineal wound, including old age, poor circulation, immobility, obesity, and other co-morbidities, this combination product successfully regenerated skin integrity and decreased periwound erythema in a very short period of time.  

Conclusion: The use of a white petrolatum and olivamine ™ skin barrier preparation in a patient with multiple devastating comorbidities successfully healed a perineal dermatitis in 6 days. Study on a larger population is currently being undertaken.