Incontinence-associated dermatitis: step-by-step prevention and treatment

Abstract

Incontinence-associated dermatitis (IAD) is one of the clinical manifestations of moisture-associated skin damage. It is a common problem in community dwelling patients with faecal and/or urinary incontinence, and IAD management is an important challenge for community nurses. The aim of this practice focused article is to provide a brief update about the evidence of: (1) the pathophysiology of IAD, (2) the differentiation between IAD and pressure ulcers, and (3) the prevention/treatment of IAD. Recommendations for patient care in the community is described with reference to a patient case study.

The effects of uncoated paper on skin moisture and transepidermal water loss in bedridden patients

“…A focus on accurate observation and differentiation, and the development of consistent protocols for prevention and treatment are highly recommended. Appropriate education must be provided to support clinicians in their daily tasks to prevent and treat skin breakdown because of incontinence (Beeckman et al. 2011a,b).…”

“…2008). Therefore, incontinence care is clearly an important task for clinicians in this area (Beeckman et al. 2011a).…”

“…Clinical studies that have evaluated intervention for prevention and treatment of IAD have included a step‐by‐step approach: Step (1) gentle cleansing of the perineal and perigenital skin, Step (2) application of a moisturiser, and Step (3) application of a skin protectant (Beeckman et al. 2011a).…”

“…When used correctly, absorptive or containment products comprise an important intervention for preventing IAD as they can help to wick liquid away from the skin (Haugen 1997). Beeckman et al. (2011a) observed in their case study that the use of blue incontinence sheets on a bed is inappropriate for the management of either urinary or liquid faecal incontinence.…”

Prevention of Incontinence-Associated Skin Damage in Nursing Homes

“…Additionally, avoidance of preventable problems, such as IASD, is a priority of consumer advocates and cost-effective healthcare delivery (Gallagher, 2011). Interventions and types of products to prevent IASD have been described by clinical experts (Beeckman, Woodward, & Gray, 2011; Nix & Haugen, 2010) Various cost-effective strategies have been used in developing skin care products for treating IASD that are also used for its prevention (Bliss, Zehrer, Savik, Smith, & Hedblom, 2007; Gray et al, 2012; Zehrer, Lutz, Hedblom, & Ding, 2004) To our knowledge, there are no studies comparing the cost of prevention versus treatment of IASD. However, others have shown that prevention of several clinical conditions, including other types of skin damage such as pressure ulcers, results in cost savings in a variety of ways (Gallagher, 2011).…”