Deprez J, Ohde N, Eilegård Wallin A, Bååth C, Hommel A, Hultin L, Josefson A, Kottner J, Beeckman D, et al.
International wound journal. Date of publication 2024 Jul 1;volume 21(7):e14962.
1. Int Wound J. 2024 Jul;21(7):e14962. doi: 10.1111/iwj.14962.
Prognostic factors for the development of incontinence-associated dermatitis
(IAD): A systematic review.
Deprez J(1)(2), Ohde N(3), Eilegård Wallin A(1), Bååth C(4)(5), Hommel A(6),
Hultin L(7), Josefson A(8)(9), Kottner J(3), Beeckman D(1)(2).
Author information:
(1)Swedish Centre for Skin and Wound Research (SCENTR), School of Health
Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
(2)Skin Integrity Research Group (SKINT), University Centre for Nursing and
Midwifery, Department of Public Health and Primary Care, Faculty of Medicine and
Health Sciences, Ghent University, Ghent, Belgium.
(3)Institute of Clinical Nursing Science, Charité Universitätsmedizin, Berlin,
Germany.
(4)Department of Health Sciences, Faculty of Health, Science and Technology,
Karlstad University, Karlstad, Sweden.
(5)Faculty of Health, Welfare and Organisation, Østfold University College,
Halden, Norway.
(6)Department of Care Science, Malmö University, Malmö, Sweden.
(7)Department of Public Health and Caring Sciences, Uppsala University, Uppsala,
Sweden.
(8)School of Medical Sciences, Faculty of Medicine and Health, Örebro
University, Örebro, Sweden.
(9)Department of Dermatology, Örebro University Hospital, Örebro, Sweden.
Incontinence-associated dermatitis (IAD) is an irritant contact dermatitis from
prolonged contact with urine or faeces, which can significantly impact patient
comfort and quality of life. The identification of prognostic factors for the
development of IAD has the potential to enhance management, support preventive
measures and guide future research. The objective of this systematic review was
to summarize the empirical evidence of prognostic factors for the development of
IAD. This study included prospective and retrospective observational studies or
clinical trials that described prognostic factors associated with IAD. There
were no restrictions on setting, time, language, participants or geographical
regions. Exclusion criteria included reviews, editorials, commentaries,
methodological articles, letters to the editor, cross-sectional and case-control
studies, and case reports. Searches were conducted from inception to April 2024
on MEDLINE, CINAHL, EMBASE and the Cochrane Library. The studies were assessed
by two independent reviewers using the QUIPS and the CHARMS-PF for data
extraction. A narrative synthesis approach was employed due to study
heterogeneity and using the 'vote counting based on direction' method and the
sign test. The overall certainty of evidence was assessed using adapted GRADE
criteria. The review included 12 studies and identified 15 potential predictors.
Moderate-quality evidence suggests that increased stool frequency, limited
mobility and friction/shear problems are risk factors for IAD development.
Female sex, older age, vasopressor use and loose/liquid stool are risk factors
supported by low-quality evidence. Increased stool frequency, limited mobility
and friction/shear problems seem to be risk factors for the development of IAD.
There is insufficient evidence to support the predictive validity of female sex,
older age, loose/liquid stool and vasopressor use. There is substantial
methodological variability across studies, making it challenging to make
comparisons. Large-scale cohort studies in different settings that incorporate
our review findings should be conducted in the future.
© 2024 The Author(s). International Wound Journal published by
Medicalhelplines.com Inc and John Wiley & Sons Ltd.
DOI: 10.1111/iwj.14962
PMCID: PMC11253026
PMID: 39016196 [Indexed for MEDLINE]
Conflict of interest statement: The authors declare that they have no conflict
of interest.
