title: Incontinence-associated dermatitis: a comprehensive review and update.
abstract: In 2009, a multinational group of clinicians was charged with reviewing and evaluating the research base pertaining to incontinence-associated dermatitis (IAD) and synthesizing this knowledge into best practice recommendations based on existing evidence. This is the first of 2 articles focusing on IAD; it updates current research and identifies persistent gaps in our knowledge. Our literature review revealed a small but growing body of evidence that provides additional insight into the epidemiology, etiology, and pathophysiology of IAD when compared to the review generated by the first IAD consensus group convened 5 years earlier. We identified research supporting the use of a defined skin care regimen based on principles of gentle perineal cleansing, moisturization, and application of a skin protectant. Clinical experience also supports application of an antifungal powder, ointment, or cream in patients with evidence of cutaneous candidiasis, aggressive containment of urinary or fecal incontinence, and highly selective use of a mild topical anti-inflammatory product in selected cases. The panel concluded that research remains limited and additional studies are urgently needed to enhance our understanding of IAD and to establish evidence-based protocols for its prevention and treatment.
authors.affiliation: University of Virginia Department of Urology and School of Nursing, Charlottesville, VA, USA. mg5k@virginia.edu
authors.forename: Mikel
authors.initials: M
authors.lastname: Gray
authors.forename: Dimitri
authors.initials: D
authors.lastname: Beeckman
authors.forename: Donna Z
authors.initials: DZ
authors.lastname: Bliss
authors.forename: Mandy
authors.initials: M
authors.lastname: Fader
authors.forename: Susan
authors.initials: S
authors.lastname: Logan
authors.forename: Joan
authors.initials: J
authors.lastname: Junkin
authors.forename: Joan
authors.initials: J
authors.lastname: Selekof
authors.forename: Dorothy
authors.initials: D
authors.lastname: Doughty
authors.forename: Peter
authors.initials: P
authors.lastname: Kurz
mesh_terms: D015400:Clinical Nursing Research; D003245:Consensus Statements as Topic; D003872:Dermatitis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D005242:Fecal Incontinence / Q000150:complications*; D006801:Humans; D010502:Perineum / Q000382:microbiology; D015995:Prevalence; D017592:Skin Care; D009626:Terminology as Topic; D014549:Urinary Incontinence / Q000150:complications* / Q000453:epidemiology; D015034:Zinc Oxide / Q000627:therapeutic use
chemical_list: D015034:Zinc Oxide