MASD part 2: Incontinence-associated dermatitis and intertriginous dermatitis: A consensus

Journal of Wound, Ostomy and Continence Nursing

Volumn 38, Issue 4, 2011, Pages 359-370

  Black, Joyce M ^a   Gray, Mikel ^b   Bliss, Donna Z ^c   Kennedy Evans, Karen L ^d   Logan, Susan ^e   Baharestani, Mona M ^f   Colwell, Janice C ^g   Goldberg, Margaret ^h   Ratliff, Catherine R ⁱ  

^a UNIVERSITY OF NEBRASKA MEDICAL CENTER   (United States)

^b UNIVERSITY OF VIRGINIA   (United States)

^c UNIVERSITY OF MINNESOTA   (United States)

^d KL Kennedy LLC   (United States)

^e Kindred Healthcare   (United States)

^f East Tennessee State University   (United States)

^g UNIVERSITY OF CHICAGO   (United States)

^h Delray Wound Treatment Center   (United States)

ⁱ UNIVERSITY OF VIRGINIA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

WATER;

CONSENSUS DEVELOPMENT; FECES INCONTINENCE; FEMALE; HUMAN; IRRITANT DERMATITIS; METHODOLOGY; MULTIMODALITY CANCER THERAPY; NURSING; NURSING ASSESSMENT; REVIEW; SKIN CARE; TREATMENT OUTCOME; URINE INCONTINENCE;

COMBINED MODALITY THERAPY; DERMATITIS, IRRITANT; FECAL INCONTINENCE; FEMALE; HUMANS; NURSING ASSESSMENT; SKIN CARE; TREATMENT OUTCOME; URINARY INCONTINENCE; WATER;

EID: 79960762057     PISSN: 10715754     EISSN: None     Source Type: Journal    
DOI: 10.1097/WON.0b013e31822272d9     Document Type: Review

References (86)

1. Gray M, Bliss DZ, Doughty DB, et al. Incontinence-associated dermatitis: a consensus. J Wound Ostomy Continence Nurs. 2007;34:45-54.
2. Gray M, Black JM, Baharestani MM, et al. Moisture-associated skin damage: overview and pathophysiology. J Wound Ostomy Continence Nurs. 2011;38:233-241
3. Bliss DZ, Savik K, Harms S, Fan Q, Wyman JF. (2006). Prevalence and correlates of perineal dermatitis in nursing home residents. Nursing Res. 2006;55:243-251. (Pubitemid 44503655)
4. Bliss DZ, Zehrer C, Savik K, Smith G, Hedblom E. An economic evaluation of four skin damage prevention regimens in nursing home residents with incontinence: economics of skin damage prevention. J Wound Ostomy Continence Nurs. 2007;34:143-152.
5. Lyder CH, Clemes-Lowrance C, Davis A, Sullivan L, Zucker A. Structured skin care regimen to prevent perineal dermatitis in the elderly. J ET Nurs. 1992;19:12-16.
6. Keller PA, Sinkovic SP, Miles SJ. Skin dryness: a major factor in reducing incontinence dermatitis. Ostomy Wound Manage. 1990;30:60-64.
7. Roe B, Flanagan L, Jack B, et al. Systematic review of the management of incontinence and promotion of continence in older people in care homes: descriptive studies with urinary incontinence as primary focus. J Adv Nurs. 2011;67:228-250.
8. Junkin J, Selekof JL. Prevalence of incontinence and associated skin injury in the acute care inpatient. J Wound Ostomy Continence Nurs. 2007;34:260-269.
9. Driver DS. Perineal dermatitis in critical care patients. Crit Care Nurs. 2007;27:42-46.
10. Bliss DZ, Johnson S, Savik K, Clabots CR, Gerding DN. Fecal incontinence in hospitalized patients who are acutely ill. Nurs Res. 2000;49:101-108.
11. Ehman S, Thorson M, Lebak K, et al. Development of perineal dermatitis in critically ill adults with fecal incontinence [abstract]. National Teaching Institute American Association of Critical Care Nurses, San Diego, CA. Am J Crit Care. 2006;15:333.
12. Bliss DZ, Lowry A, Whitebird R, et al. Absorbent product use and incontinence associated dermatitis in community-living persons with fecal incontinence [abstract]. International Continence Society; 2008.
13. Warner MR, Taylor JS, Leow YH. Agents causing contact urticaria. Clin Dermatol. 1997;15:623-635. (Pubitemid 27315186)
14. Berg RW, Milligan MC, Sarbaugh FC. Association of skin wetness and pH with diaper dermatitis. Pediatr Dermatol. 1994; 11:18-20. (Pubitemid 24085969)
15. Davis JA, Leyden JJ, Grove GL, Raynor WJ. Comparison of disposable diapers with fluff absorbent and fluff plus absorbent polymers: effects on skin hydration, skin pH, and diaper dermatitis. Pediatr Dermatol. 1989;6:102-108. (Pubitemid 19170463)
16. Berg RW. Etiologic factors in diaper dermatitis: a model for development of improved diapers. Pediatrician. 1987;14(suppl 1): 27-33. (Pubitemid 17112752)
17. Berg RW, Buckingham KW, Stewart RL. Etiologic factors in diaper dermatitis: the role of urine. Pediatr Dermatol. 1986;3: 102-106. (Pubitemid 16129245)
18. Buckingham KW, Berg RW. Etiologic factors in diaper dermatitis: the role of feces. Pediatr Dermatol. 1986;3:107-112. (Pubitemid 16129246)
19. Scheinfeld N. Diaper dermatitis: a review and brief survey of eruptions of the diaper area. Am J Clin Dermatol. 2005;6:273-281. (Pubitemid 41577402)
20. Leyden JJ, Katz S, Stewart R, Kligman AM. Urinary ammonia and ammonia-producing microorganisms in infants with and without diaper dermatitis. Arch Dermatol. 1977:113;1678-1680. (Pubitemid 8241735)
21. Aly R, Shirley C, Cunico B, Maibach HI. Effect of prolonged occlusion on the microbial flora, pH, carbon dioxide and transepidermal water loss on human skin. J Invest Dermatol. 1978;71:378-381. (Pubitemid 9104276)
22. Farage MA, Miller KW, Berardesca E, Maibach HI. Incontinence in the aged: contact dermatitis and other cutaneous consequences. Contact Dermat. 2007;57:211-217. (Pubitemid 47397794)
23. Brown DS. Perineal dermatitis risk factors: clinical validation of a conceptual framework. Ostomy Wound Manage. 1995;41:46-48, 50, 52-53.
24. Bliss DZ, Zehrer C, Savik K, Thayer D, Smith G. Incontinenceassociated skin damage in nursing home residents: a secondary analysis of a prospective, multicenter study. Ostomy Wound Manage. 2006;52:46-55.
25. Atherton DJ. The etiology and management of irritant diaper dermatitis. J Eur Acad Dermatol Venereol. 2001;15(suppl 1):1-4. (Pubitemid 33019609)
26. Zimmerer RE, Lawson KD, Calvert CJ. The effects of wearing diapers on skin. Pediatr Dermatol. 1986;3:95-101. (Pubitemid 16129244)
27. Defloor T, Schoonhoven L, Fletcher J, et al. Statement of the European Pressure Ulcer Advisory Panel-pressure ulcer classification: differentiation between pressure ulcers and moisture lesions. J Wound Ostomy Continence Nurs. 2005;32:302-306. (Pubitemid 41454471)
28. Maklebust J, Magnan MA. Risk factors associated with having a pressure ulcer: a secondary data analysis. Adv Wound Care. 1994;7:25, 27-28, 31-34.
29. Fader M, Clarke-O'Neill S, Cook D, et al. Management of nighttime urinary incontinence in residential settings for older people: an investigation into the effects of different pad changing regimes on skin health. J Clin Nurs. 2003;12:374-386. (Pubitemid 37266834)
30. Fader M, Clarke-O'Neill S, Cook D, Cottenden A, Malone-Lee J. An investigation into night-time self-turning by nursing home residents. J Clin Nurs. 2003;12:147-148. (Pubitemid 37260034)
31. Nix DH. Validity and reliability of the Perineal Assessment Tool. Ostomy Wound Manage. 2002;48:43-46, 48-49.
32. Brown DS, Sears M. Perineal dermatitis: a conceptual framework. Ostomy Wound Manage. 1993;39:20-22, 24-25.
33. Kennedy KL, Lutz L. Comparison of the efficacy and costeffectiveness of three skin protectants in the management of incontinent dermatitis. Paper presented at: Proceedings of the European Conference on Advances in Wound Management; October 4, 1996; Amsterdam.
34. Borchert K, Bliss DZ, Savik K, Radosevich DM. The incontinence-associated dermatitis and its severity instrument: development and validation. J Wound Ostomy Continence Nurs. 2010; 37:527-535.
35. Andersen ES, Karlsmark T. Evaluation of four non-invasive methods for examination and characterization of pressure ulcers. Skin Res Technol. 2008;14:270-276.
36. Quintavalle PR, Lyder CH, Mertz PJ, Phillips-Jones C, Dyson M. Use of high-resolution, high-frequency diagnostic ultrasound to investigate the pathogenesis of pressure ulcer development. Adv Skin Wound Care. 2006;19:498-505.
37. Bates-Jensen BM, McCreath HE, Pongquan V. Subepidermal moisture is associated with early pressure ulcer damage in nursing home residents with dark skin tones: pilot findings. J Wound Ostomy Continence Nurs. 2009;36:277-284.
38. Black J, Baharestani M, Cuddigan J, et al; National Pressure Ulcer Advisory Panel. National Pressure Ulcer Advisory Panel's updated pressure ulcer staging system. Adv Skin Wound Care. 2007;20:269-274.
39. Byers PH, Ryan PA, Regan MB, Shields A, Carta SG. Effects of incontinence care cleansing regimens on skin integrity. J Wound Ostomy Continence Nurs. 1995;22:187-192.
40. Lewis-Byers K, Thayer D. An evaluation of two incontinence skin care protocols in a long-term care setting. Ostomy Wound Manage. 2002;48:44-51.
41. Voegeli D. The effect of washing and drying practices on skin barrier function. J Wound Ostomy Continence Nurs. 2008;35: 84-90.
42. Rönner AC, Berland CR, Runeman B, Kaijser B. The hygienic effectiveness of 2 different skin cleansing procedures. J Wound Ostomy Continence Nurs. 2010;37:260-264.
43. Armstrong DG, Ayello EA, Capitulo KL, et al. New opportunities to improve pressure ulcer prevention and treatment: implications of the CMS Inpatient Hospital Care Present on Admission (POA) indicators/Hospital-Acquired Conditions (HAC) policy, a consensus. 2008.
44. Bliss DZ, Savik K. Use of an absorbent dressing specifically for fecal incontinence. J Wound Ostomy Continence Nurs. 2008;35: 221-228.
45. Giamundo P, Welber A, Weiss EG, et al. The procon incontinence device: a new nonsurgical approach to preventing episodes of fecal incontinence. Am J Gastroenterol. 2002;97:2328-2332.
46. Herbert J. Use of anal plugs in faecal incontinence management. Nurs Times. 2008;104:66-68.
47. Benoit RA, Watts C. The effect of a pressure ulcer prevention program and the bowel management system in reducing pressure ulcer prevalence in an ICU setting. J Wound, Ostomy Continence Nurs. 2007;34:163-175.
48. Evans EC, Gray M. What interventions are effective for the prevention and treatment of cutaneous candidiasis? J Wound Ostomy Continence Nurs. 2003;30:11-16. (Pubitemid 36877360)
49. Bjorserud C, Olbers T, Olsen MF. Patients' experience of surplus skin after laparoscopic gastric bypass. Obes Surg. 2011; 21:273-277.
50. McMahon R. The prevalence of skin problems beneath the skin of in-patients. Nurs Times. 1991;87:48-51.
51. Brown J, Wimpenny P, Maughan H. Skin problems in people with obesity. Nurs Stand. 2004;18:38-42.
52. Janniger CK, Schwartz RA, Szepietowski JC, Reich A. Intertrigo and common secondary skin infections. Am Fam Physician. 2005;72:833-838.
53. Hahler B. An overview of dermatological conditions commonly associated with the obese patient. Ostomy Wound Manage. 2006;52:34-36, 38, 40.
54. Laube S, Farrell AM. Bacterial skin infections in the elderly: diagnosis and treatment. Drugs Aging. 2002;19:331-342. (Pubitemid 34804179)
55. García-Hidalgo L, Orozco-Topete R, Gonzalez-Barranco J, et al. Dermatoses in 156 obese adults. Obes Res. 1999;7:299-302. (Pubitemid 129710590)
56. García Hidalgo L. Dermatological complications of obesity. Am J Clin Dermatol. 2002;3:497-506. (Pubitemid 35007067)
57. Yosipovitch G, Tur E, Cohen O, Rusecki Y. Skin surface pH in intertriginous areas in NIDDM patients: possible correlation to candidal intertrigo. Diabetes Care. 1993;16:560-563. (Pubitemid 23097200)
58. Löffler H, Aramaki JU, Effendy I. The influence of body mass index on skin susceptibility to sodium lauryl sulphate. Skin Res Technol. 2002;8:19-22. (Pubitemid 34555460)
59. Rutkowski JM, Davis KE, Scherer PE. Mechanisms of obesity and related pathologies: the macro- and microcirculation of adipose tissue. FEBS J. 2009;276:5738-5746.
60. Kanof NB, Blau S. Intertrigo and heat rash. J Occup Med. 1964;6:302-303.
61. Waisman M. Intertriginous moniliasis. Postgrad Med. 1963;33: 323-326.
62. McMahon R. Buckeldee J. Skin problems beneath the breasts of in-patients: the knowledge, opinions and practice of nurses. J Adv Nurs. 1992;17:1243-1250.
63. Mistiaen P, Poot E, Hickox S, Jochems C, Wagner C. Preventing and treating intertrigo in the large skin folds of adults: a literature overview. Dermatol Nurs. 2004;16:43-46, 49-57.
64. Arndt K, Bowers K. Manual of Dermatologic Therapeutics. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2002.
65. Selden S. Intertrigo. J Cutan Med Surg. 2003;7:330-332.
66. Rand CS, Macgregor AM. Morbidly obese patients' perceptions of social discrimination before and after surgery for obesity. South Med J. 1990;83:1390-1395.
67. Todar K. The normal bacterial flora of humans. In: Todar's Online Textbook of Bacteriology. Published 2008. http://www.textbookofbacteriology.net/ Accessed March 6, 2011.
68. Honig PJ, Frieden IJ, Kim HJ, Yan AC. Streptococcal intertrigo: an underrecognized condition in children. Pediatrics. 2003;112: 1427-1429. (Pubitemid 37523434)
69. Silvestre JF, Betlloch MI. Cutaneous manifestations due to Pseudomonas infection. Int J Dermatol. 1999;38:419-431. (Pubitemid 29287635)
70. Edwards C, Cuddigan J, Black J. Identification of Organisms Colonized at Site of Intertriginous Dermatitis in Hospitalized Patients. Toronto, Ontario, Canada: World Union of Wound Healing Societies; 2008.
71. Schmid-Wendtner MH, Korting HC. The pH of the skin surface and its impact on the barrier function. Skin Pharmacol Physiol. 2006;19:296-302. (Pubitemid 44808083)
72. Scheinfeld N. Infections in the elderly. Dermatol Online J. 2005;11:8.
73. Laube S. Skin infections and ageing. Ageing Res Rev. 2004;3:69-89. (Pubitemid 38177439)
74. Kennedy-Evans KL, Henn T, Levine N. Skin and wound care for the bariatric patient. In: Krasner DL, Rodeheaver G, Sibbald RG, eds. Chronic Wound Care: A Clinical Source Book for Healthcare Professionals. 4th ed. Malvern, PA: HMP Communications; 2007; pp 695-699.
75. Kaya TI, Delialioglu N, Yazici AC, Tursen U, Ikizoglu G. Medical pearl: blue underpants sign-a diagnostic clue for Pseudomonas aeruginosa intertrigo of the groin. J Am Acad Dermatol. 2005; 53:869-871. (Pubitemid 41501380)
76. Wolf R, Orion E, Matz H. The baboon syndrome or intertriginous drug eruption: a report of eleven cases and a second look at its pathomechanism. Dermatol Online J. 2003;9:2.
77. Aly R, Forney R, Bayles C. Treatments for common superficial fungal infections. Dermatol Nurs. 2001;13:91-94, 98-99.
78. McMahon R. An evaluation of topical nursing interventions in the treatment of submammary lesions. J Wound Care. 1994;3:365-366.
79. Davis SA. How I treat groin eruptions. Med Times. 1980;108:54-55, 58-59.
80. Fragola LA, Watson PE. Common groin eruptions: diagnosis and treatment. Postgrad Med. 1981;69:159-163, 166-169, 172.
81. Gallagher Camden S. Skin care needs of the obese patient. In: Bryant RA, Nix DP, eds. Acute & Chronic Wounds: Current Management Concepts. 4th ed. St Louis, MO: Elsevier Mosby; 2012:477-484.
82. Chadbourne EB, Zhang S, Gordon MJ, et al. Clinical outcomes in reduction mammaplasty: a systematic review and meta-analysis of published studies. Mayo Clin Proc. 2001; 76:503-510. (Pubitemid 32423134)
83. Dohvoma C, Hutchison I, Calvert M. Labiomental intertrigo. An indication for orthognathic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79:551-553.
84. Hoggarth A, Waring M, Alexander J, Greenwood A, Callaghan T. A controlled, three-part trial to investigate the barrier function and skin hydration properties of six skin protectants. Ostomy Wound Manage. 2005;51:30-42.
85. Zehrer CL, Newman DK, Grove GL, Lutz JB. Assessment of diaper-clogging potential of petrolatum moisture barriers. Ostomy Wound Manage. 2005;51:54-58.
86. Guitart J, Woodley DT. Intertrigo: a practical approach. Compr Ther. 1994;20:402-409.