Prevention and treatment of incontinence-associated dermatitis: Literature review

Medicine and Health Sciences, Ghent University, Belgium.
Journal of Advanced Nursing (Impact Factor: 1.74). 05/2009; 65(6):1141-54. DOI: 10.1111/j.1365-2648.2009.04986.x
Source: PubMed


This paper is a report of a review conducted to describe the current evidence about the prevention and treatment of incontinence-associated dermatitis and to formulate recommendations for clinical practice and research.
Incontinence-associated dermatitis is a common problem in patients with incontinence. It is a daily challenge for healthcare professionals to maintain a healthy skin in patients with incontinence.
PubMed, Cochrane, Embase, the Cumulative Index to Nursing and Allied Health Literature, reference lists and conference proceedings were explored up to September 2008.
Publications were included if they reported research on the prevention and treatment of incontinence-associated dermatitis. As little consensus about terminology was found, a very sensitive filter was developed. Study design was not used as a selection criterion due to the explorative character of the review and the scarce literature.
Thirty-six publications, dealing with 25 different studies, were included. The implementation of a structured perineal skin care programme including skin cleansing and the use of a moisturizer is suggested. A skin protectant is recommended for patients considered at risk of incontinence-associated dermatitis development. Perineal skin cleansers are preferable to using water and soap. Skin care is suggested after each incontinence episode, particularly if faeces are present. The quality of methods in the included studies was low.
Incontinence-associated dermatitis can be prevented and healed with timely and appropriate skin cleansing and skin protection. Prevention and treatment should also focus on a proper use of incontinence containment materials. Further research is required to evaluate the efficacy and effectiveness of various interventions.

Download full-text


Available from: Alexander Heyneman, Jun 02, 2015
  • Source
    • "Systematic Reviews Hodgkinson et al (2006) (2007) 22 Beeckman et al (2009) 2 "
    [Show abstract] [Hide abstract]
    ABSTRACT: Patients in acute and long-term care settings receive daily routine skin care, including washing, bathing, and showering, often followed by application of lotions, creams, and/or ointments. These personal hygiene and skin care activities are integral parts of nursing practice, but little is known about their benefits or clinical efficacy. The aim of this article was to summarize the empirical evidence supporting basic skin care procedures and interventions and to develop a clinical algorithm for basic skin care. Electronic databases MEDLINE, EMBASE, and CINAHL were searched and afterward a forward search was conducted using Scopus and Web of Science. In order to evaluate a broad range of basic skin care interventions systematic reviews, intervention studies, and guidelines, consensus statements and best practice standards also were included in the analysis. One hundred twenty-one articles were read in full text; 41documents were included in this report about skin care for prevention of dry skin, prevention of incontinence-associated dermatitis and prevention of skin injuries. The methodological quality of the included publications was variable. Review results and expert input were used to create a clinical algorithm for basic skin care. A 2-step approach is proposed including general and special skin care. Interventions focus primarily on skin that is either too dry or too moist. The target groups for the algorithm are adult patients or residents with intact or preclinical damaged skin in care settings. The goal of the skin care algorithm is a first attempt to provide guidance for practitioners to improve basic skin care in clinical settings in order to maintain or increase skin health.
    Full-text · Article · Jul 2015 · Journal of wound, ostomy, and continence nursing: official publication of The Wound, Ostomy and Continence Nurses Society / WOCN
  • Source
    • "The need for systems change: reflections on knowledge translation and organizational change 5 13 11 11 (Robson et al. 2009) Original Research Standardized antibacterial honey (Medihoney (TM)) with standard therapy in wound care: randomized clinical trial 6 12 18 18 (Levett-Jones et al. 2009) Original Research Staff–student relationships and their impact on nursing students' belongingness and learning 7 12 16 15 (Bours et al. 2009) Review Paper Bedside screening tests vs. videofluoroscopy or fibreoptic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: systematic review 8 11 20 20 (Karahan et al. 2009) Original Research Low back pain: prevalence and associated risk factors among hospital staff 9 11 16 11 (Beeckman et al. 2009) Review Paper Prevention and treatment of incontinence-associated dermatitis: literature review 10 11 13 13 (Duval et al. 2009) "

    Full-text · Article · Nov 2013 · Journal of Advanced Nursing
  • Source
    • "Chemical and physical stimuli due to frequent cleansing enhance skin permeability and decrease skin barrier function. These factors weaken the skin, which then triggers IAD [6]. Randomized, controlled trials (RCT) investigating effective management of IAD through skin care programs or the use of incontinence pads have been previously conducted. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Most older adults with urinary incontinence use absorbent pads. Because of exposure to moisture and chemical irritating substances in urine, the perineal skin region is always at risk for development of incontinence-associated dermatitis (IAD). The aim of this study was to examine the efficacy of an improved absorbent pad against IAD. A cluster randomized controlled design was used to compare the efficacy of two absorbent pads. Female inpatients aged ≥65 years who had IAD and used an absorbent pad or diaper all day were enrolled. Healing rate of IAD and variables of skin barrier function such as skin pH and skin moisture were compared between the usual absorbent pad group (n = 30) and the test absorbent pad group (n = 30). Thirteen patients (43.3%) from the test absorbent pad group and 4 patients (13.3%) from the usual absorbent pad group recovered completely from IAD. Moreover, the test absorbent pad group healed significantly faster than the usual absorbent pad group (p = 0.009). On the other hand, there were no significant differences between the two groups in skin barrier function. The test absorbent pad for older adults with urinary incontinence might be more efficacious against IAD than usual absorbent pad. UMIN-CTR: UMIN000006188.
    Full-text · Article · May 2012 · BMC Geriatrics
Show more