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Tuesday, January 11, 2011

Skin Health and Incontinence Part 3

By Kimberly Crews, LPN, BBA

Prevention is key with any medical condition or issue.  Incontinence associated dermatitis (IAD) is no exception.  By preventing IAD we decrease the risk of fungal and bacterial infections.

Nutrition and hydration are key to maintaining health in general; it is a key factor in tissue integrity of the body.  Staying well hydrated is essential for the derma layer of skin to maintain moisture, but moisture is the enemy of the outer layer of the epidermis.

When preventing and treating IAD we need to identify the reason for incontinence.  If possible treat the cause of incontinence and this improves quality of life.  Keep a regular check on skin and its tone in the perineal area.  During incontinent product changes check skin for any reddened areas or inflamed areas.  It is essential to perform proper peri care on any incontinent individual. When performing peri care be sure to follow the How To of  Peri Care listed on the prevail.com page.  While cleansing area be sure not to scrub as friction from scrubbing can cause further skin damage.

It is suggested to use a product with ph level close to the skin. Prevail adult wash cloths are pre moistened wipes and are ideal for peri care.  Soap does not have the same ph and can cause further breakdown.  Apply any needed creams, like zinc oxide as needed.  Be sure to read the directions on the manufacture label as application is different for each manufacture.

Take care of yourself inside and you will see the benefits on the outside.

Monday, November 15, 2010

Skin Health and Incontinence Part 2

By Kimberly Crews, LPN, BBA
Skin Health and Incontinence Part 2:
Once the skin begins to break down you will begin to develop dermatitis in the perianal area.  In infants this is referred to as diaper rash.  With adults it is often referred to as perineal dermatitis, contact dermatitis, heat rash, moisture associated skin damage, irritant dermatitis and incontinence associated dermatitis.
Incontinence Associated Dermatitis (IAD) is constant exposure with urine and fecal matter in the perineal area causing inflammation to the skin. As the skin begins to breakdown you begin to lose the protective barrier your skin provides.  While hydrating our bodies from the inside is essential to life, but when epidermis is in contact with moisture for extended period of time skin damage occurs and the result is IAD.  Often IAD is treated as a pressure ulcer. To better understand IAD below you will find the etiology and characteristics of incontinence associated dermatitis.
The etiology of IAD is based on 3 principals and their determining factors are:
-Tissue Tolerance including your age, health, hydration and nutritional status, oxygenation, perfusion and body temperature
-Perineal Environment including urine/fecal incontinence and volume of output,
Chafing and irritants (creams, ointments etc that are unnecessary)
-Toileting Ability including mobility, sensory perception and cognitive awareness (ability to know when to go and how to get there)
Physical characteristics of IAD related to urine and fecal incontinence are the following:
-Inflammation of surface of skin
-Redness, edema (swelling) areas may appear patchy or consolidated (located in the labia majoria (vaginal area) on women or scrotum of men)
-Erosion and dehydration of superficial layers of skin
People often relate the feeling of IAD to a burn on the skin.  It is often itchy, burning, and/or tingling.  The longer the skin is exposed to the urine/stool the more it affects the area and increases breakdown.  To help prevent IAD a consistent skin care program is necessary.  Use a premoist wash cloth, like Prevail adult washcloths to clean after incontinence episodes.  Avoid scrubbing the area and only gently wash the area.  See the other articles on proper Peri Care listed on the Prevail website.
Once the skin begins to break down you will begin to develop dermatitis in the perianal area.  In infants this is referred to as diaper rash.  With adults it is often referred to as perineal dermatitis, contact dermatitis, heat rash, moisture associated skin damage, irritant dermatitis and incontinence associated dermatitis.
Incontinence Associated Dermatitis (IAD) is constant exposure with urine and fecal matter in the perineal area causing inflammation to the skin. As the skin begins to breakdown you begin to lose the protective barrier your skin provides.  While hydrating our bodies from the inside is essential to life, but when epidermis is in contact with moisture for extended period of time skin damage occurs and the result is IAD.  Often IAD is treated as a pressure ulcer. To better understand IAD below you will find the etiology and characteristics of incontinence associated dermatitis.
The etiology of IAD is based on 3 principals and their determining factors are:
  • Tissue Tolerance including your age, health, hydration and nutritional status, oxygenation, perfusion and body temperature
  • Perineal Environment including urine/fecal incontinence and volume of output, Chafing and irritants (creams, ointments etc that are unnecessary)
  • Toileting Ability including mobility, sensory perception and cognitive awareness (ability to know when to go and how to get there)
Physical characteristics of IAD related to urine and fecal incontinence are the following:
  • Inflammation of surface of skin
  • Redness, edema (swelling) areas may appear patchy or consolidated (located in the labia majoria (vaginal area) on women or scrotum of men)
  • Erosion and dehydration of superficial layers of skin
People often relate the feeling of IAD to a burn on the skin.  It is often itchy, burning, and/or tingling.  The longer the skin is exposed to the urine/stool the more it affects the area and increases breakdown.  To help prevent IAD a consistent skin care program is necessary.  Use a premoist wash cloth, like Prevail adult washcloths to clean after incontinence episodes.  Avoid scrubbing the area and only gently wash the area.  See the other articles on proper Peri Care listed on the Prevail website.
Monday, May 10, 2010

Myth or Fact: “Incontinence is a natural part of aging and is inevitable.”

By Christine Pruneau, RN, BSN

Myth or Fact? The Truth about Incontinence: “Incontinence is a natural part of aging and is inevitable.”

MYTH!

Many people believe that urinary incontinence is a normal part of aging. Though it is somewhat common, it is not considered normal by medical experts. Incontinence is very manageable.

People (often Seniors) with urinary incontinence don’t always seek advice from professionals. They try to deal with the problem themselves but are not always successful. They may limit trips outside their homes and needlessly isolate themselves from friends and family. Falls and fractures are not uncommon as they race to a bathroom so as not to embarrass themselves by being wet. Other conditions such as urinary tract infections and skin breakdown are a result of poor management of incontinence.

Urinary incontinence is not a normal part of aging. To help, start by bringing up the subject with your doctor or a nurse. Once health care professionals are informed of a potential issue, they can pursue the matter in a tactful and helpful way. Many primary care practitioners already inquire about incontinence during patient visits. Tell them the truth about what you are experiencing. They have many ways they can help.

This web site has a number of helpful hints to manage urinary incontinence at home. Read this post from January 13th, 2010 for helpful hints about talking to your healthcare professional. You might also read the Jan. 5th posting about foods and beverages that can influence urinary incontinence. Kimberly Crew’s “Incontinence Product Overview” can guide you as to how to find the proper products to manage any difficulties.

Feel free to discuss this post on our forum by clicking here.