Pure Omental Lipid (P.O.L.) for the treatment of fragile skin: A Pharmacological and Clinical Review

Abstract

The omentum is a large peritoneal fold. It begins at the stomach and extends down-wards to cover the abdominal organs. It serves a primarily protective role, especially in defending against infective agents and to promote tissue reparation after injuries. The omentum is characterized by extensive vascularization, sign of a metabolically active environment. Furthermore, omentum is the tissue with the highest production of vascular endothelial growth factor (VEGF) in the body. The lipids contained in this tissue carry out very important activities for the organism, and the presence of neutral glycerides, phospholipids, glycolipids, and gangliosides suggests the potential usefulness of heterologous omental lipid fractions in dermatology. Omentum stimulates vascular proliferation, therefore is possible to speculate its topical use in therapies designed to regenerate skin tissue in clinical conditions characterized by fragile skin. Dermatological products containing purified omental lipids are commercially available. Pure porcine omental lipids (P.O.L.) could be use in topical products in different textures (cream, fluid, emulsions, and cleanser) and at different concentrations (10-25%) for the treatment of fragile skin or other skin conditions at risk of ulcer formation (the so-called dermatoporosis of the elderly, severe skin xerosis in diabetic subjects, skin at risk of pressure ulcers). This review summarizes the pharmacological rationale of purified porcine omental lipids in topical formulations for the use in fragile skin conditions and the clinical efficacy data available in the scientific literature. Several clinical controlled trials conducted in 320 subjects have shown that topical porcine purified omental lipids are able to prevent the formation of pressure ulcers in hospitalized high-risk subjects, to improve wound healing process, to normalize skin hydration in diabetic subjects with moderate-severe skin xerosis and to improve clinical evolution of diabetic foot. Therefore, purified omental lipid could be an effective tool for the management of fragile skin and the skin at high risk of ulcer formation.