Management of incontinence-associated dermatitis patients using a skin protectant in acute care: a case series

J Wound Care. 2020 Jan 2;29(1):18-26. doi: 10.12968/jowc.2020.29.1.18.

Abstract

Objective: Incontinence-associated dermatitis (IAD) is a common type of irritant contact dermatitis. It is categorised by persistent erythema and can be associated with denudation and/or colonisation and infection. IAD is challenging to treat and affects 3.4-50% of patients. This case series evaluates a novel, elastomeric, advanced skin protectant (3M Cavilon Advanced Skin Protectant) in a UK acute health-care setting, for the management of IAD in patients suffering from moisture-associated skin damage (MASD) in the sacral/genital area.

Method: The patient's skin was assessed by clinicians using the GLOBIAD classification tool at the point of recruitment and to monitor progress throughout the study period. The product was applied as a single layer in accordance with the instructions for use. Patients, when able, were asked to assess their own pain level using the Wong-Baker FACES pain scale. Photographs were taken as part of the ongoing assessment.

Results: The skin protectant was used on average every 2.28 days. Of the 18 IAD patients recruited, 79% (n=11) were classified as IAD-free, based on the GLOBIAD categorisation tool, by the end of the evaluation period. Skin deterioration during the evaluation period was seen in one patient (6%), and of the patients able to complete pain assessments, 55% (n=6) reported a reduction in pain.

Conclusion: These results suggest that the elastomeric skin protectant, applied every three days, plays a role in the improvement of IAD. The skin protectant adheres to wet and weeping partial-thickness wounds and may aid IAD management. Reducing application to every third day supports a change in practice which may offer benefits to patients and caregivers.

Keywords: barrier; case series; evaluation; incontinence-associated dermatitis; moisture associated skin damage; skin protectant.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Buttocks
  • Cyanoacrylates / administration & dosage*
  • Dermatitis, Irritant / etiology
  • Dermatitis, Irritant / prevention & control
  • Dermatitis, Irritant / therapy*
  • Elastomers / administration & dosage*
  • Fecal Incontinence / complications*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Protective Agents / administration & dosage*
  • Skin / injuries
  • Skin Care / methods
  • Urinary Incontinence / complications*

Substances

  • Cyanoacrylates
  • Elastomers
  • Protective Agents