Bliss DZ, Savik K, Thorson MA, Ehman SJ, Lebak K, Beilman G, et al.
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy an.... Date of publication 2011 Jul 1;volume 38(4):433-45.
1. J Wound Ostomy Continence Nurs. 2011 Jul-Aug;38(4):433-45. doi:
10.1097/WON.0b013e318220b703.
Incontinence-associated dermatitis in critically ill adults: time to
development, severity, and risk factors.
Bliss DZ(1), Savik K, Thorson MA, Ehman SJ, Lebak K, Beilman G.
Author information:
(1)University of Minnesota School of Nursing, Minneapolis, MN, USA.
PURPOSE: The purpose of this study was to determine the time to development,
severity, and risk factors of incontinence-associated dermatitis (IAD) among
critically ill patients with fecal incontinence.
SUBJECTS AND SETTING: Forty-five patients with a mean age of 49.4 ± 18.5 years
(mean ± SD) in the surgical/trauma critical care unit (ICU) of 1 of 3 urban
hospitals who were free of any perineal skin damage at study start participated
in the study. The majority (76%) were male.
METHODS: Surveillance of skin for IAD and chart review of data initially and
daily.
RESULTS: Incontinence-associated dermatitis developed in 36% of patients. The
median time to onset of IAD was 4 days (range, 1-6). Eighty-one percent of
patients still had IAD at discharge from the ICU and at the end of their
surveillance (median time = 7 days, range, 1-19 days). The severity of erythema
associated with IAD was mild, moderate, or severe for 13%, 11%, or 4% (means) of
the time patients were observed. Denudement occurred 9% of the observed time.
Frequent incontinence of loose or liquid stools and diminished cognitive
awareness were significant independent risk factors for development of IAD
sooner.
CONCLUSION: Incontinence-associated dermatitis develops in critically ill
patients with fecal incontinence relatively quickly and does not resolve in most
before their discharge from the ICU. Early monitoring and prevention of IAD,
especially in patients with diminished cognition or with frequent leakage of
loose or liquid feces, are recommended to promote skin health.
DOI: 10.1097/WON.0b013e318220b703
PMID: 21747261 [Indexed for MEDLINE]
