The 2 essential steps for IAD (Incontinence-Associated Dermatitis) prevention and a healthy perineum skin

Skin affected by incontinence-associated dermatitis
Incontinence related to aging or reduced mobility is a well-recognized risk factor for several other health complications when not properly cared for.

Inadequate Incontinence care often leads to Incontinence-Associated Dermatitis (IAD). Incontinence-associated dermatitis is a “form of irritant dermatitis that develops from chronic exposure to urine or liquid stool.”(1)

The management of IAD is crucial in preventing other complications such as the formation of pressure ulcers. Implementing and following a proper incontinence care protocol can result in a significantly lower incidence of IAD and can, therefore, minimize the recovery time and the cost involved in treating pressure ulcers.

How to implement a structured skin care regimen for IAD prevention?

A structured skin care regimen consists of two main steps: CLEANSING and PROTECTING, and in more severe cases, a third step – helping the skin to RESTORE faster.

1. Cleansing the skin – CLEANSE

The cleansing step consists of removing the urine and/or faeces, i.e., the source of irritants that cause IAD. This should be done before applying a skin protectant as part of a routine process after an incontinence episode.
According to research about the management of IAD

A skin cleanser with a pH range similar to normal skin is preferred over traditional soap. (2)

The difference between traditional soap and a skin cleanser is that conventional soap is usually alkaline and has been shown to change skin pH, potentially damaging the skin’s barrier function. In addition, it can leave residues in the skin folds, leading to further skin irritation.
According to experts, “the use of no-rinse cleansers suitable for the management of incontinence is recommended.”(3)

2. Protecting the skin – PROTECT

The second step, the skin protectant, is crucial to minimize exposure to urine and/or faeces and friction. A skin protector should form a barrier between the skin and any moisture or potential irritant and should be applied at a frequency consistent with its ability to protect the skin. 

Among all the ingredients used as a barrier against the acid in urine and feaces, Dimethicone is one of the best options. This ingredient has the advantage of being non-occlusive and it becomes transparent after application, which allows assessing the skin without the need to remove it. A skincare product or a combination product with skin protective/restorative actions is recommended to prevent IAD in at-risk patients.

Perineal Skin Improvement in 3 days with Swash Perineum for IAD prevention

 

3. Additional step – Helping the skin to RESTORE faster

Patients may benefit from an additional RESTORE step to support and maintain skin barrier function. This is achieved using a suitable leave-on skincare product intended to reduce dryness and restore the lipid matrix.
Restoring skincare products is diverse and can contain a wide variety of ingredients. That is why it’s important that caregivers check the ingredients of any product to be applied to a patient’s skin. In addition, they need to ensure that the product does not contain any substance to which the patient is sensitive or allergic.

What are the solutions for Incontinence management offered by Arion?

As a European market leader in bathing with pre-moistened gloves and wipes, Arion offers an entire Swash® product range for incontinence management. Swash® Perineum products are combined leave-on products aimed to Clean, Care, Protect and help to Restore the skin.
The lotion formulation used in these products is developed and controlled in Arion’s in-house Research and Development Laboratory. This secures better access to the quality and efficacy of the product, continuous lotion improvements, and new innovative ways for Incontinence Care.

The effectiveness of Swash® Perineum Wipes for incontinence care has been proven during a controlled study conducted in 2017 by Olga Isart Bosch, a nurse at Hospital de Barcelona – SCIASa. The objective of the study was to investigate if the usage of special Swash® Perineum Wipes can reduce the IAD incidence, compared to traditional incontinence care. 

The results of the study indicate that:

“Under the conditions of our study: according to the results obtained we can say that the use of the special wipes Swash® Perineum for perineal care decreases the incidence of IAD compared to conventional hygiene. The resolution of IAD in the experimental group was almost 20 percentage points greater than in the control group.”
Nurse Olga Isart Bosch, Hospital de Barcelona, SCIAS

REFERENCES

  1. Incontinence-Associated Dermatitis: State of the Science and Knowledge Translation, Advances in Skin & Wound Care, 2018

  2. Incontinence-Associated Dermatitis: Moving prevention forward, Dimitri Beeckman, Wounds International, 2015
  3. Incontinence-Associated Dermatitis: Moving prevention forward, Dimitri Beeckman, Wounds International, 2015
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