The effectiveness of a hydrocolloid crusting method versus standard care in the treatment of incontinence-associated dermatitis among adult patients in an acute care setting: A randomised controlled trial.

Autor: Gunasegaran N; Nursing Division, Singapore General Hospital, Singapore. Electronic address: nanthakumahrie.gunasegaran@sgh.com.sg., Ang SY; Nursing Division, Singapore General Hospital, Singapore. Electronic address: ang.shin.yuh@singhealth.com.sg., Ng YZ; Skin Research Institute of Singapore, Singapore. Electronic address: yizhen.ng@sris.a-star.edu.sg., Lee NES; Skin Research Institute of Singapore, Singapore. Electronic address: e0540048@u.nus.edu., Agus N; Nursing Division, Singapore General Hospital, Singapore. Electronic address: leeyannaa@gmail.com., Lee CW; Nursing Division, Singapore General Hospital, Singapore. Electronic address: lee.chee.woei@sgh.com.sg., Ong CE; Nursing Division, Singapore General Hospital, Singapore. Electronic address: ong.choo.eng@sgh.com.sg., Mostafa SS; Nursing Division, Singapore General Hospital, Singapore. Electronic address: sri.sukarti.mostafa.abdollah@sgh.com.sg., Aloweni F; Nursing Division, Singapore General Hospital, Singapore. Electronic address: fazila.abu.bakar.aloweni@sgh.com.sg.
Jazyk: angličtina
Zdroj: Journal of tissue viability [J Tissue Viability] 2023 May; Vol. 32 (2), pp. 171-178. Date of Electronic Publication: 2023 Jan 23.
DOI: 10.1016/j.jtv.2023.01.007
Abstrakt: Introduction: Incontinence-associated dermatitis (IAD) is a type of irritant contact dermatitis due to prolonged exposure of the skin to moisture induced by urine or/and faeces. The main principles when treating IAD involves protecting the skin from further exposure to irritants, establishing a healing environment, and eradicating skin infections. This study aimed to evaluate the effectiveness of the hydrocolloid crusting method (HCM) versus the standard care method (SCM) in treating IAD.
Method: A randomised controlled trial was conducted in an acute tertiary hospital in Singapore between August 2019 to September 2021. Using computer-generated numbers, patients were randomised into either HCM or SCM treatment groups. HCM treatment involved cleansing the affected area with a pH-neutral non-rinse moisturising cleanser, and the application of alternate layers of hydrocolloid powder, and non-sting film barrier spray (repeated three times during each use). Patients in the SCM treatment group received the same cleanser followed by a 30% zinc oxide barrier cream. IAD was assessed daily for up to seven days by the wound care nurses using the IAD severity tool. The primary outcome of the study was the mean difference in IAD score per day between both methods.
Results: Forty-four patients were eligible and recruited (22 in HCM; 22 in SCM). Patients in both groups were comparable in age and gender. IAD Category 2 was more predominant in both methods. The most common location of IAD was at the perianal skin and diarrhea related to gastroenteritis was the most prevalent cause of IAD. More patients in the SCM group (n = 12; 54.5%) had their IAD healed within seven days compared to HCM, (n = 7; 31.8%) group. However, the average decrease in IAD scores per day for both methods were found to be similar.
Conclusion: HCM can be considered as a treatment of IAD along with the use of SCM. A skin care regimen should include effective cleansing, skin protection, and moisturization in IAD management.
Competing Interests: Declaration of competing interest Nil.
(Copyright © 2023 Tissue Viability Society / Society of Tissue Viability. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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