Effectiveness of skin cleanser and protectant regimen on incontinence‐associated dermatitis outcomes in acute care patients: A cluster randomised trial

Abstract

Skin cleansers and protectants protect skin from incontinent matter to reduce the risk of incontinence-associated dermatitis (IAD), but their effectiveness treating established IAD in the tropics is unknown. We conducted an open-label cluster randomised trial to compare the effectiveness of a combined regimen of (1) specialised skin cleansers with disposable body wipes and (2) either an acrylic terpolymer (T1) or zinc oxide (T2) skin protectant against disposable body wipes and zinc oxide protectant (control) in promoting IAD healing and reducing the risk of deterioration. Eighty-four patients were recruited in a tertiary hospital in Singapore between April 2019 and January 2020 (T1: n = 23; T2: n = 37; Control: n = 24). Although not statistically significant, patients treated with T1 and T2 were 1.5 times as likely to experience IAD healing within seven days compared with the control (P = .66). Healing was more pronounced in participants with skin loss treated with T1 or T2. No treatment was superior in preventing IAD deterioration, the prevalence of which remained small (8%-14%). While skin cleaning and protectants reduced the overall risk of skin deterioration, the addition of skin cleansers enhanced IAD healing within a short period, an important consideration for future research examining IAD treatment in acute care.

Efficacy, effectiveness, usability and acceptability of devices for female urinary incontinence: A scoping review

“…IADs cause discomfort, sleep quality disturbances and can be complicated by bacterial and fungal superinfections due to proximity to the anus and can also cause urinary tract infections. For this reason, positive results in terms of reduction of IAD and protection from the same must be considered by nurses who manage women with urinary incontinence (Glass et al, 2021).…”

“…Discomfort can affect sleep, and moisture further predisposes to urinary tract infections. IAD sites are also more prone to bacterial and/or fungal infections due to their proximity to the gastrointestinal and urinary tracts (Glass et al, 2021). Regardless of type, incontinence has been shown to have a detrimental impact on patient health‐related quality of life (Coyne et al, 2003), indeed physical symptoms of UI have a huge impact on quality of life (QoL) (Nightingale, 2020).…”

“…Discomfort can affect sleep, and moisture further predisposes to urinary tract infections. IAD sites are also more prone to bacterial and/or fungal infections due to their proximity to the gastrointestinal and urinary tracts (Glass et al, 2021).…”

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

“…Current prevention strategies focus on minimising skin exposure to incontinence using absorbent products, removing irritants by cleansing with soap and water and protecting the skin with barrier products, which are not sufficient. 19 , 20 In particular, these approaches have been linked with disruption of skin barrier functionality by increasing transepidermal water loss (TEWL) and by influencing skin microclimate, such as temperature and humidity, leading to increased skin sensitivity and susceptibility to damage. 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.…”

Corrigendum

“…In the article [ 1 ], acrylic terpolymer should be replaced with cyanoacrylate tetrapolymer throughout the article. The affected sentences should have been:…”