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 |
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| Institution: | 1. Nursing Division, Singapore General Hospital, Singapore;2. Skin Research Institute of Singapore, Singapore;1. School of Nursing and Midwifery, Monash University, Level 3, Building 13D, Clayton Campus, 35 Rainforest Walk, Clayton, VIC, 3800, Australia;2. Department of Physiotherapy, Monash University, Building B, Peninsula Campus, 47-49 Moorooduc Highway, Frankston, VIC, 3199, Australia;1. Higher Institute of Nursing Professions and Health Techniques (ISPITS), Tetouan, 93000, Morocco;2. Research Team in Pedagogical Engineering and Science Didactics (ERIPDS), Ecole Normale Supérieure (ENS), Abdelmalek Essaadi University, Tetouan, 93000, Morocco;1. Department of Physical Medicine and Rehabilitation, National Rehabilitation Center, Seoul, South Korea;2. Department of Rehabilitative and Assistive Technology, National Rehabilitation Center, Seoul, South Korea;3. Department of Nursing, National Rehabilitation Center, Seoul, South Korea;1. School of Nursing, Fuzhou Institute of Technology, 8 Xijiangbin Avenue, Fuzhou, Fujian, China;2. School of Nursing, Fujian University of Traditional Chinese Medicine, 1 Qiu Yang Road, Fuzhou, Fujian, China;3. Department of General Surgery, Zhongshan Hospital, Xiamen University, 201 South Hubin Road, Siming District, Fujian Province, China;4. Teaching and Research Department, Fuzong Clinical Medical College of Fujian Medical University, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China;5. School of Nursing, Putian University, 1133 Xueyuan Middle Road, Putian, Fujian, China;1. School of Nursing and Midwifery Griffith University, Australia;2. NHMRC Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland and School of Nursing and Midwifery Griffith University, Gold Coast, Australia;3. Department of Biostatistics, Faculty of Medicine, Istanbul Aydin University, Istanbul, Turkey |
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| Abstract: | IntroductionIncontinence-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.MethodA 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.ResultsForty-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.ConclusionHCM 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. |
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| Keywords: | Incontinence-associated dermatitis Hydrocolloid Crusting Barrier cream Nursing Wound care Zinc oxide |
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