Kon Y, Ichikawa-Shigeta Y, Iuchi T, Nakajima Y, Nakagami G, Tabata K, Sanada H, Sugama J, et al.
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy an.... Date of publication 2017 Sep 1;volume 44(5):481-486.
1. J Wound Ostomy Continence Nurs. 2017 Sep/Oct;44(5):481-486. doi:
10.1097/WON.0000000000000353.
Effects of a Skin Barrier Cream on Management of Incontinence-Associated
Dermatitis in Older Women: A Cluster Randomized Controlled Trial.
Kon Y(1), Ichikawa-Shigeta Y, Iuchi T, Nakajima Y, Nakagami G, Tabata K, Sanada
H, Sugama J.
Author information:
(1)Yuka Kon, MHS, RN, Department of Clinical Nursing, Institute of Medical,
Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan. Yoshie
Ichikawa-Shigeta, PhD, RN, Department of Gerontological Nursing/Wound Care
Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Terumi Iuchi, PhD, RN, Department of Clinical Nursing, Institute of Medical,
Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan. Yukari
Nakajima, MHS, RN, Department of Clinical Nursing, Institute of Medical,
Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan. Gojiro
Nakagami, PhD, RN, Department of Gerontological Nursing/Wound Care Management,
Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Keiko
Tabata, RN, Sengi Hospital, Asanogawa Medical Corporation, Kanazawa, Japan.
Hiromi Sanada, PhD, WOCN, RN, Department of Gerontological Nursing/Wound Care
Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Junko Sugama, PhD, RN, Advanced Health Care Science Research UnitInnovative
Integrated Bio-Research CoreInstitute for Frontier Science Initiative, Kanazawa
University, Ishikawa, Japan.
PURPOSE: The purpose of this study was to examine the effects of a skin barrier
cream with moisturization and skin-protectant characteristics for improving the
severity of incontinence-associated dermatitis (IAD) pertaining to the skin
physiology and appearance. We measured the following outcomes: (1) skin
physiological characteristics indicating skin protection and enhancement of the
skin's moisture barrier (stratum corneum hydration, dermis hydration level,
transepidermal water loss, and skin pH); and (2) changes in skin appearance (the
degree of erythema and pigmentation, and the sulcus cutis condition).
DESIGN: Single-blind, cluster randomized controlled trial.
SUBJECTS AND SETTING: The study was conducted in a long-term care facility in
Japan between November 7, 2011, and May 6, 2012. We used block randomization to
obtain a random sample of 6 (4 experimental and 2 control) out of 10 available
wards. All subjects were elderly women with IAD of the buttock or inner thigh.
We assessed 295 patients, but only 33 met inclusion criteria; 18 were allocated
to the experimental group and 15 were allocated to the control group.
METHODS: All participants were managed with cleansing with a skin cleanser and
application of a moisturizer daily. In addition, a skin barrier cream designed
to enhance the skin's moisture barrier and act as a protective barrier was
applied to the skin of patients in the experimental group 3 times a day when
absorptive briefs were changed. Skin physiological and appearance
characteristics were scored only at the buttock or thigh area. All data were
collected on days 1 and 14 of the study.
RESULTS: Univariate analysis found that the erythema index was lower in the
intervention group than in the control group at day 14 (P = .004). Multivariate
analysis found significant associations between use of the skin barrier cream
and increased stratum corneum hydration (β= .443, P = .031), decreased skin pH
(β=-.439, P = .020), and magnitude of erythema (β=-.451, P = .018).
CONCLUSIONS: Study findings suggest that a barrier cream designed to enhance the
skin's moisture barrier and act as a skin protectant increased stratum corneum
hydration, reduced cutaneous pH, and reduced erythema.
DOI: 10.1097/WON.0000000000000353
PMID: 28723852 [Indexed for MEDLINE]
