IMPAIRED SKIN INTEGRITY SKIN
Is there a correlation between the incontinence level and the potential skin damage? Are there other important factors?Īlthough the presence of incontinence is a prerequisite, not all incontinent patients develop skin damage. This may be due to diarrhea, frequent stools, tight diapers, overexposure to ammonia, or even allergic reactions Irritant diaper dermatitis develops when skin is exposed to prolonged wetness, and a reaction to urine and/or faeces increases the skin pH, then resulting in breakdown of the stratum corneum, or outermost layer of the skin. Although children experience many of the same skin problems well described in adult patients, unique challenges do present in the young population.
Epidermal disruptions from skin contact with urine or stool, can leave a child’s skin susceptible to infection. It is well known that alterations in skin integrity represent a serious and often preventable problem in pediatric care as well. Skin is more fragile when people are older, nevertheless, does this mean that there is no risk for younger people to suffer from skin problems associated with bladder control issues? IAD can result in an undue burden of care, loss of independence, disruption in activities and/or sleep, and reduced quality of life, worsening with frequency and quantity of soiling. Patients with IAD can experience discomfort, pain, burning, itching or tingling in the affected areas. Incontinence and its associated skin damage can have a considerable effect on the patients physical and psychological well-being.
In adults, the terminology of perineal dermatitis has commonly been used, but more recently it has been proposed that incontinence-associated dermatitis (IAD) is a better term because affected skin areas are not confined to the perineum. Skin irritation within the pad occlusion area is usually termed diaper dermatitis in infants. Associated skin damage is the main physical health consequence of urinary and faecal incontinence. Up to 10% of adults can experience an episode of faecal incontinence during the lifespan. Faecal incontinence is a hidden problem being under-diagnosed, underinvestigated and under-treated. Prevalence figures rise with increasing age and in women aged over 70 years more than 40% of the population is affected by urinary incontinence. Population studies from numerous countries report that urinary incontinence prevalence ranges between 5% and 70%, with most studies reporting a prevalence in the range of 25-45%. Incontinence is any accidental or involuntary loss of urine from the bladder (urinary incontinence) or bowel motion, faeces or wind from the bowel (faecal incontinence). Why is skin important when considering incontinence care? He holds international Fellowships such as Sigma Theta Tau International Honour Society of Nursing and the European Academy of Nursing Science.
He is in the editorial board of the Journal of Wound, Ostomy and Continence Nursing, Journal of Tissue Viability, and BMC Geriatrics. He authored over 140 scientific publications and presented his research in > 60 countries. He specialises in skin integrity research, clinical trials, education, implementation and instrument development and psychometrics. He is President of the European Pressure Ulcer Advisory Panel (EPUAP) and the International Skin Tear Advisory Panel (ISTAP) and Council Member of the European Wound Management Association (EWMA). He is a Visiting Professor at the Royal College of Surgeons in Ireland, Monash University (Australia), and the University of Southern Denmark. Dimitri Beeckman is a Professor of Skin Integrity and Clinical Nursing at Ghent University (Belgium) and Örebro University (Sweden).
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