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Saving skin from irritation and infection

Reducing the risk of IAD is the focus of a new care plan.

Experts on incontinence-associated dermatitis (IAD) are advocating a management plan that helps patients avoid incontinence-related skin issues. IAD is painful, often likened to burns on an individual’s buttocks and thighs, and each episode of incontinence requires a clean-up that can prove excruciating. 

The pain associated with IAD often increases morbidity and potentially the length of hospitalisation. It can also render the patient uncooperative if asked to walk about or sit up in a chair, and vulnerable to the hazards of immobility.

According to Professor Dedee Murrell, head of dermatology at St George Hospital, IAD and allergies can contribute significantly to a patient’s discomfort and treatment requirements.

“If a patient suffers from an incontinence-related infection or irritation, the sensations include excruciating pain and sensitivity, and burning and itching around the crotch and buttock areas,” Murrell says.

“The increased potential risk of an elderly patient developing septicaemia could even cause death. We are much better off preventing irritations through sensible skin care with appropriate products.”

However she warns some pads can increase skin temperature and raise the pH-value of the underlying skin, resulting in itching and redness.

A warm, moist environment is also ideal for bacterial growth, further complicating a person’s dermatological management, Murrell says.

“As a person ages their skin becomes thin, fragile and less resilient to the external environment. Incontinence pads that are made of poor quality materials such as plastic can cause sweating and discomfort, and can trap urine against the skin rather than withdrawing it, resulting in maceration,” she says.

“IAD not only affects people living in aged care and hospital settings. In Australia’s warm climate, many incontinent people living at home are also susceptible to IAD and allergies.”

In response to the need for products that manage incontinence episodes, Paul Hartmann has developed a range of hypoallergenic continence products for those at risk of IAD.

The Hartmann continence product range contains a three-part absorbent core comprising a dry plus curled fibre top which draws away liquid quickly, a super absorbent polymer (SAP) and cellulose inner-core, and a stabilising cellulose base layer.

This three-part absorbent core, along with built-in leakage cuffs, ensures the pad does not have to be changed until it is three-quarters full.

The products also have breathable air active side panels that have been dermatologically proven to reduce skin irritation and maintain a healthy skin temperature, odour neutralising molecules and additional leakage barriers to better manage incontinence episodes.

The products also have a pH buffer that helps maintain the skin’s natural pH level of 5.5.

Long-term complications of IAD can include additional medications, higher continence product demands, disruption to a patient’s daily nursing routines and additional doctor and allied health visits, Murrell says.

“Nurses also have a double duty of care. They must do what they can to care for a patient, however, they also need to protect themselves from poor skin health,” she says.

“Washing their hands constantly, wearing gloves all day, and applying barrier cream increases their risk of developing hand eczema, and nurses working in an aged care setting are exposed to an increased risk of catching scabies.

“If there are products available that reduce the risk of IAD, allergies and discomfort in a patient and also reduce the need for nurses to treat them, they should be used.”

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