Transepidermal water loss in newborn infants. I. Relation to ambient humidity and site of measurement and estimation of total transepidermal water loss.

Insensible water loss (IWL) is an important factor in the thermoregulation and water balance of the newborn infant. A method for direct measurement of the rate of evaporation from the skin surface has been developed. The method, which is based on determination of the vapour pressure gradient close to the skin surface, allows free evaporation. From measurements performed on 19 newborns placed in incubators, a linear relation was found between the evaporation rate (ER) and the humidity of the environment at a constant ambient temperature. A 40% lower ER was recorded at a high relative humidity (60%) than at a low one (20%) in the incubator. At measurements on different sites of the body, a high ER was observed on the face and peripheral parts of the extremities, while ER at other sites was relatively low. By determining ER from different parts of the body and calculating the areas of the corresponding surfaces, the total cutaneous insensible water loss for the infant in question could be obtained. The transepidermal water loss (TEWL) for the whole body surface area was calculated to be 8.1 g/m2h. On the basis of measurements performed it was found that the total cutaneous insensible water loss can be estimated with a reasonable degree of accuracy by recording ER from only three easily accessible measurement points.