Incontinence-associated dermatitis in the elderly: treatment options

Abstract

Incontinence-associated dermatitis (IAD) is a common problem in older people. However, it is frequently misdiagnosed and poorly treated. There is often uncertainty about which product to use to prevent and treat IAD; the different types, brands and how to apply them. This literature review looks specifically at the use of barrier products in the prevention and treatment of IAD. A systematic search found six primary research papers that analysed the effectiveness of various barrier products; they will be compared and contrasted in this review. There is a lack of evidence to recommend any one barrier product over another for use in a standardised skin care protocol such as the regimen suggested by Gray et al (2012). More research needs to be conducted to establish the most effective barrier products on the market. More research is also needed on the efficacy of barrier products in the prevention and treatment solely of IAD rather than combined studies looking at IAD with pressure ulcers.

Moisture-associated skin damage: use of a skin protectant containing manuka honey

“…Certain groups of patients are more at risk of IAD, including babies and young children still wearing nappies, older people (Corcoran and Woodward, 2013) and those who are critically ill (Beele et al, 2018). In older people the skin has reduced epidermal thickness, increasing the risk of skin breakdown, as well as urinary and faecal incontinence being most prevalent in this age group (Van Damme et al, 2017).…”

“…There are few comparative studies of barrier products, with many of the studies that have been undertaken having poor methodological quality (Corcoran and Woodward, 2013;Beeckman et al, 2016), so there is insufficient evidence on which to recommend one product over any other. Anecdotal evidence suggests that barrier products may be misused in clinical practice, with nurses applying them in too great a quantity.…”

“…This can result in the skin breaking down, permitting bacteria to enter (Beeckman et al, 2015). Subsequent infections in the stratum corneum can result in irritation and inflammation, further depleting the skin's barrier properties (Corcoran and Woodward, 2013).…”

İnkontinansa Bağlı Dermatit: Değerlendirme, Önleme ve Tedavi

“…İBD'nin yaygınlığı, inkontinans ile paralellik göstermektedir 10 . İBD, özellikle yaşlılarda sık görülen bir sorun olmasına rağmen bu durum sıklıkla gözden kaçırılmaktadır 11 . Literatürde İBD prevelansı %5.6-%50; insidansı %3,4-%25 arasında değişmektedir 2,9,[12][13][14][15] .…”

Turkish Adaptation and Validity and Verification Percentages Study of the Incontinence-Associated Dermatitis and Its Severity Instrument

“…(3,4) Her ne kadar İBD, yaşlı popülasyonda sık karşılaşılan bir sorun olsa da sıklıkla fark edilememektedir. (3,5) Literatürde İBD prevalansının %5.6-%50; insidansın ise %3,4-%25 arasında değiştiği görülmektedir. (2,(6)(7)(8)(9)(10) Amerika Birleşik Devletleri (ABD)'nde Bliss ve arkadaşları (10) lojistik regresyon analizi ile huzur evinde 59558 hastanın hemşirelik kayıtlarını incelemişlerdir.…”