The effectiveness of faecal collection devices in preventing incontinence-associated dermatitis in critically ill patients with faecal incontinence: A systematic review and meta-analysis |
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| Authors: | Yan Zhang Minmin Leng Jinli Guo Junfang Duan Zhiwen Wang |
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| Affiliation: | 1. Department of Critical Care Medicine, The Second Hospital of Shanxi Medical University, No. 382 of Wuyi Road, Xinghualing District, Taiyuan, 030001, China;2. School of Nursing, Peking University, Beijing, 100191, China;3. Peking University Health Science Centre for Evidence-Based Nursing: A Joanna Briggs Institute Affiliated Group, Beijing, 100191, China;4. Department of Nursing, The Second Hospital of Shanxi Medical University, Taiyuan, 030001, China;1. Gold Coast Health, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Queensland, 4215, Australia;2. Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Queensland, 4222, Australia;3. School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, University of the Sunshine Coast, 90, Sippy Downs Drive, Sippy Downs, Queensland, 4556, Australia;1. Alfred Intensive Care Unit, Alfred Health, 55 Commercial Road, Melbourne, 3181, Victoria, Australia;2. La Trobe University, Alfred Clinical School of Nursing, 99 Commercial Road, Melbourne, 3004, Victoria, Australia;3. Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia;1. Intensive Care Unit, Royal Adelaide Hospital, Port Road, Adelaide, South Australia, 5000, Australia;2. Department of Nuclear Medicine and Bone Densitometry, Royal Adelaide Hospital, Port Road, Adelaide, South Australia, 5000, Australia;3. Director of Intensive Care Clinical Research Unit, Royal Adelaide Hospital, Port Road, Adelaide, South Australia, 5000, Australia;1. Alliance for Vascular Access Teaching and Research Group, Menzies Health Institute Queensland, Brisbane, Queensland, Australia;2. School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia;3. The Royal Brisbane and Women''s Hospital, Brisbane, Queensland, Australia;4. The Prince Charles Hospital, Brisbane, Queensland, Australia;5. The Princess Alexandra Hospital, Brisbane, Queensland, Australia;6. School of Medicine, Griffith University, Queensland, Australia;7. Centre for Applied Health Economics, Menzies Health Institute, Queensland, Australia;8. Queensland Children''s Hospital, Brisbane, Queensland, Australia;9. The University of Queensland, Brisbane, Queensland, Australia;1. Malcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, NSW, Australia;2. Critical Care Division, The George Institute for Global Health, Sydney, NSW, Australia |
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| Abstract: | ObjectiveThe objective of this study was to investigate the effects of different types of faecal collection devices on incontinence-associated dermatitis (IAD) in critically ill patients with faecal incontinence.Review method usedThis was a systematic review and meta-analysis.Data sourcesA comprehensive electronic literature search was performed in PubMed, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL), the Cochrane library, China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wanfang, and WeiPu. All the databases were searched from their inception to July 31, 2019, and the data were updated on November 2, 2019.Review methodsRandomised controlled trials (RCTs) and quasi-experimental studies were included. Participants were critically ill patients with faecal incontinence, and the interventions involved care with faecal collection devices. Comparisons were usual care, and the outcome was the incidence of IAD. Odds ratios (ORs) were used to calculate the pooled effect sizes. Heterogeneity was tested using the inconsistency index (I2) method.ResultsNineteen studies were included in this systematic review including 16 RCTs and three quasi-experimental studies. Twelve RCTs were included in the meta-analysis, which showed that the use of faecal collection devices significantly reduced the incidence of IAD. Subgroup analyses based on device type showed significant effects for anal pouch collection devices (OR, 0.14; 95% confidence interval [CI], 0.07–0.26; P < 0.00001), anal pouch connected to negative-pressure suction devices (OR, 0.18; 95% CI, 0.08–0.42; P < 0.00001), anal catheter/tube collection devices (OR, 0.24; 95% CI, 0.13–0.44; P < 0.00001), and anal catheter/tube connected to negative-pressure suction devices (OR, 0.20; 95% CI, 0.07–0.59, P < 0.00001).ConclusionsFaecal collection devices can reduce the incidence of IAD in critically ill patients with faecal incontinence. It is suggested that when using a device to care for critically ill patients with faecal incontinence, an anal pouch connected to continuous low-negative-pressure suction device should be preferred. Further high-quality research is still needed regarding anal catheter/tube collection devices and anal catheter/tube connected to continuous low-negative-pressure suction devices. |
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| Keywords: | Faecal collection devices Faecal incontinence Incontinence-associated dermatitis Critical care Meta-analysis |
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