Beeckman D
Journal of tissue viability. Date of publication 2017 Feb 1;volume 26(1):47-56.
1. J Tissue Viability. 2017 Feb;26(1):47-56. doi: 10.1016/j.jtv.2016.02.004. Epub
2016 Feb 21.
A decade of research on Incontinence-Associated Dermatitis (IAD): Evidence,
knowledge gaps and next steps.
Beeckman D(1).
Author information:
(1)University Centre for Nursing and Midwifery, Department of Public Health,
Ghent University, Ghent, Belgium. Electronic address: Dimitri.Beeckman@UGent.be.
BACKGROUND: Incontinence-Associated Dermatitis (IAD) is one of the clinical
manifestations of Moisture- Associated Skin Damage (MASD). IAD is a common
problem in aged patients with fecal and/or urinary incontinence.
AIM: Update about IAD terminology, etiology, epidemiology, observation,
prevention, and treatment.
METHODS: Integrative review.
RESULTS: The lack of an ICD-10 code and an internationally validated and
standardized method for IAD data collection contribute to a variation in
epidemiological data. Frequent episodes of incontinence (especially fecal),
occlusive containment products, poor skin condition, reduced mobility,
diminished cognitive awareness, inability to perform personal hygiene, pain,
pyrexia, certain medications (antibiotics, immunosuppressants), poor nutritional
status, and critical illness are associated with IAD. Correctly diagnosing IAD
and distinguish it from pressure ulcers is difficult. Even though the clinical
presentation of partial thickness pressure ulcers and IAD is similar, the
underlying etiologic factors differ. However, incontinence and IAD were found to
be risk factors for pressure ulcer development. IAD management should
essentially focus on skin cleansing to remove dirt, debris and microorganisms;
skin moisturization to repair or augment the skin's barrier; and the application
of a skin barrier product to prevent skin breakdown by providing an impermeable
or semi-permeable barrier on the skin. The body of evidence is still limited,
but growing since the last decade.
CONCLUSION: Incontinence causes disruptions of the skin barrier function and
leads to superficial skin damage. Macerated skin and superficial skin changes
due to incontinence are associated with pressure ulcer development. Skin
maceration, chemical irritation, and physical irritation should be targeted to
effectively prevent and treat IAD.
Copyright © 2016 Tissue Viability Society. Published by Elsevier Ltd. All rights
reserved.
DOI: 10.1016/j.jtv.2016.02.004
PMID: 26949126 [Indexed for MEDLINE]
