Prevention and Care for Incontinence-Associated Dermatitis Among Older Adults: A Systematic Review

Samoraphop Banharak; Ladawan Panpanit; Suttinan Subindee; Patcharawan Narongsanoi; Panisara Sanun-Aur; Walaiporn Kulwong; Pachareeporn Songtin; Wanida Khemphimai

doi:10.2147/JMDH.S329672

Prevention and Care for Incontinence-Associated Dermatitis Among Older Adults: A Systematic Review

J Multidiscip Healthc. 2021 Oct 26:14:2983-3004. doi: 10.2147/JMDH.S329672. eCollection 2021.

Authors

Samoraphop Banharak¹, Ladawan Panpanit¹, Suttinan Subindee¹, Patcharawan Narongsanoi², Panisara Sanun-Aur³, Walaiporn Kulwong⁴, Pachareeporn Songtin⁵, Wanida Khemphimai⁶

Affiliations

¹ Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand.
² Nursing Department, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand.
³ Nursing Department, Bungkla Hospital, Buengkan, Thailand.
⁴ Nursing Department, Banmuang Hospital, Sakon Nakhon, Thailand.
⁵ Nursing Department, Nong Han Hospital, Udon Thani, Thailand.
⁶ Nursing Department, Phimai Hospital, Nakhon Ratchasima, Thailand.

Abstract

Background: The prevalent rate of incontinence-associated dermatitis (IAD) trends upward in older populations. Skin breakdown from IAD impacts the quality of life of older adults and reflects the quality of care in hospitals and long-term care facilities. Specific and appropriate interventions for prevention and care are needed. This systematic review aims to review optimal strategies for prevention and care for older adults with IAD.

Methods: PubMed, CINAHL, SCOPUS, Medline, ProQuest, ThaiLIS, ThaiJo, and E-Thesis were searched for articles published between January 2010 and December 2020. Only articles focusing on older adults were included for the review.

Results: Eleven articles met the inclusion/exclusion criteria. Interventions for the prevention and care of IAD among older adults were categorized as assessment, incontinence management/causative factors management, cleansing, application of medical products for both skin moisturizing and skin barrier, body positioning, nutrition promotion, health education and training, and outcome evaluation. Specific prevention and care strategies for older adults with IAD included using specific assessment tools, applying skin cleansing pH from 4.0 to 6.8, body positioning, and promoting food with high protein. Other strategies were similar to those reported for adult patients.

Conclusion: The systematic review extracted current and specific prevention and care strategies for IAD in older adults. The prevention and care strategies from this systematic review should be applied in clinical practice. However, more rigorous research methodology is recommended in future studies, especially in examining intervention outcomes. Nurses and other health professionals should be educated and trained to understand the causes of IAD in older adults and the specific prevention and care strategies for this population. Because older adults are prone to skin damage, and this type of skin breakdown differs from pressure ulcers, the tools for assessment and evaluation, and the strategies for prevention and care require special attention.

Prospero registration number: CRD42021251711.

Keywords: incontinence-associated dermatitis; moisture-associated skin damage; older adults; skin barrier function; skin breakdown; systematic review.

Publication types

Review

Grants and funding

Grant Information: this work was financially supported by the Research and Training Center of Enhancing Quality of Life of Working Age People (Grant Number QWFM64-003), Research Cluster in Gerontological Nursing, Faculty of Nursing, Khon Kaen University (Grant Number FM64-1-2-2-3) and Research and Graduate Studies, Khon Kaen University (Grant Number GS64-1-2-2-3). Appreciation is extended to these research cluster and training centers for making the research possible.