Development of an Animal Model for Inducing Various Degrees of Severity of Incontinence-Associated Dermatitis

Wen, Zunjia; Zhu, Weipei; Liu, Qiaoyan; Zhang, Haiying; Mei, Binbin; Shen, Meifen

doi:10.1097/won.0000000000000370

Cited by 5 publications

(3 citation statements)

References 16 publications

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“…Incontinence‐associated dermatitis (IAD) (also called diaper dermatitis or perineal dermatitis) refers to skin injury and inflammation caused by repeated and long‐term exposure of the skin to urine or faeces. It is a common form of skin injury encountered in clinical settings (Wen et al., ). The major characteristics of IAD include erythema, reddish rash, skin impregnation, erosion or desquamation—with or without infection—mostly in the hip, perineum or groin (Beeckman, ; Campbell, Coyer, & Osborne, ).…”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors of incontinence‐associated dermatitis among patients in the intensive care unit

Wang

Zhang

et al. 2018

Journal of Clinical Nursing

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Section: Introductionmentioning

confidence: 99%

Incidence and risk factors of incontinence‐associated dermatitis among patients in the intensive care unit

Wang

Zhang

et al. 2018

Journal of Clinical Nursing

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“…Mugita et al (18) applied protease-containing agarose gel to the back skin of male SD rats for 4 h, followed by inoculation with Pseudomonas aeruginosa for 30 min. Wen et al (19) established an IAD model on the back of guinea pigs by using different concentrations of pancreatin solution, confirming that increased pancreatic juice concentration may lead to more severe skin reactions and higher IAD scores. In addition, Biçer et al (20) performed an ileostomy in rats to establish an ileostomy-related dermatitis model and used ozone to treat the resulting dermatitis.…”

Section: Discussionmentioning

confidence: 94%

Establishment of incontinence‑associated dermatitis rat models and assessment of the therapeutic effects of zinc oxide, painless skin protective film and silicone dressing

et al. 2021

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The aim of the present study was to construct incontinence-associated dermatitis (IAD) rat models and observe the therapeutic effects of zinc oxide, painless skin protective film and silicone dressing on IAD. A total of 54 rats were randomly divided into nine groups: i) Control group; ii) trypsin model group; iii) model + zinc oxide group; iv) model + painless skin protective film group; v) model + silicon dressing group; vi) synthetic urine combined with trypsin model group (joint model group); vii) joint model + zinc oxide group; viii) joint model + painless skin protective film group; and ix) joint model + silicone dressing group. A total of 4 days after applying the zinc oxide, protective film or silicon dressing intervention, IAD scores and pH values in skin tissues were examined. Skin tissues and blood samples were collected. Hematoxylin and eosin staining, immunohistochemical staining of major histocompatibility complex class II (MHC-II) and western blot analysis of MHC-II, NF-κB/p65, phosphorylated (p)-NF-κB/p65, STAT1 and p-STAT1 were carried out in skin tissue. Serum IFN-γ, IL-1β, IL-2 and TNF-α levels were determined using ELISA. The results demonstrated that IAD scores and pH values were both higher in the model groups than the control, which were significantly ameliorated by silicone dressing. The skin tissue structure of IAD rats both in trypsin model group and joint model group was severely damaged, the wounds were not covered by epidermis, and numerous inflammatory cell infiltrations were observed. After treatment, dermatitis was improved. Skin tissue from the trypsin and joint IAD models had higher MHC-II, NF-κB p65, p-NF-κB p65, STAT1 and p-STAT1 expression than controls, which was decreased by protective film and silicon dressing. Zinc oxide reduced NF-κB p65, p-NF-κB p65, STAT1 and p-STAT1 expression. However, no significant differences were observed in NF-κB/p-NF-κB ratio and STAT1/p-STAT1 ratio among groups. Furthermore, serum IFN-γ, IL-1β, IL-2 and TNF-α levels were significantly elevated in trypsin and joint IAD rats. The upregulation of these cytokines was significantly inhibited after all three treatments. Among the three treatment methods, silicone dressing had the best therapeutic effect. Thus, these findings revealed that zinc oxide, painless skin protective film and silicone dressing could ameliorate the severity of IAD rat models, and that silicone dressing possessed the best therapeutic effect.

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“… 21 , 22 For this reason, it is imperative to develop innovative interventions not only to prevent IAD but also to reduce the incidence of pressure injuries. Previous studies focused on digestive enzymes and bacteria, 12 , 13 , 23 and in this study we aimed to develop an appropriate animal model of IAD that reproduces the irritant response of IAD induced by urine and bacteria. This will enable an in‐depth investigation of the pathophysiology and allow us to examine possible targeted prevention strategies.…”

Section: Introductionmentioning

confidence: 99%

Bacterial invasion into the epidermis of rats with sodium lauryl sulphate‐irritated skin increases damage and induces incontinence‐associated dermatitis

Koudounas

Minematsu

Mugita

et al. 2022

International Wound Journal

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Incontinence‐associated dermatitis (IAD) is caused by prolonged exposure to urine/liquid stool. It is a common and often painful skin condition in older incontinent adults because of poor prevention. Patients with urinary infections are at risk of developing IAD, and to guide the development of novel prevention strategies, we aimed to develop an animal model of IAD by urine and bacteria. First, contralateral sites on the dorsal skin of Sprague–Dawley rats were compromised by sodium lauryl sulphate (SLS), simulating frequent cleansing with soap/water. Filter discs were then placed inside ring‐shaped chambers on foam dressings, inoculated with or without Pseudomonas aeruginosa, covered with agarose gels immersed in cultured filtrated urine, and secured in place with an occlusive dressing for 3 days. Untreated and SLS‐compromised sites served as controls. The IAD was developed at bacteria‐inoculated sites, characterised by severe IAD‐like redness that persisted for up to 3 days post‐exposure and higher disruption of the skin barrier function compared with non‐inoculated sites. Pathological changes included epidermal thickening, partial skin loss, inflammatory cell infiltration, accumulation of red blood cells, and invasion of bacteria into the epidermis. This novel, clinically relevant IAD rat model can serve for future prevention developments.

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Development of an Animal Model for Inducing Various Degrees of Severity of Incontinence-Associated Dermatitis

Abstract: Exposure of a guinea pig animal model to 1%, 5%, and 10% pancreatin solutions over a 3-day period induced IAD with different levels of severity. Additional studies using this model are warranted.

Cited by 5 publications

References 16 publications

Incidence and risk factors of incontinence‐associated dermatitis among patients in the intensive care unit

Incidence and risk factors of incontinence‐associated dermatitis among patients in the intensive care unit

Establishment of incontinence‑associated dermatitis rat models and assessment of the therapeutic effects of zinc oxide, painless skin protective film and silicone dressing

Bacterial invasion into the epidermis of rats with sodium lauryl sulphate‐irritated skin increases damage and induces incontinence‐associated dermatitis

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