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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.

Peri care is important for the health and well being of individuals.  By developing a good peri care routine you decrease the risk of infections, odor and maintain healthy habits.  The genital area is made up of skin, moist areas, and glands, which makes the peri area prone to infections.  Secretions are normal in genitals but if you notice an odor or discharge please consult your health care provider.

The basics for peri care are the same for female/male. It should be performed daily and anytime you are incontinent of urine and/or bowel.  Below are the basics supplies for peri care:

*    Luke warm water (not hot)

•    Peri wash and soft washcloth or disposable washcloths, dry towel

•    Moisturizer (may contain humectants and emollient)

•    Skin protectants if desired (these may contain petrolatum, zinc oxide, dimethicone or combination of any of these products)

Care for Female:

•    Wash the inner legs and peri area outside labia

•    Use clean area of washcloth for each wipe of peri area

•    Wash genitals from front to back (this keeps fecal matter from the anal area making its way to the urethra)

•    Rinse starting with innermost area and proceed outward

•    Wash and rinse anal area

Care for Male:

•    Using circular motion gently wash penis from tip downward

•    Uncircumcised penis retract foreskin wash and rinse tip replace skin

•    Wash and rinse scrotum

•    Wash and rinse anal area

Pat peri area dry after washing, DO NOT rub.  Apply moisturizers and/or protectant cream as desired.  When applying the creams be sure to follow manufactures directions for application.  If you are using a powder do not shake over body, as particles may get in the air and cause respiratory issues.  Be sure to always wash hands before and after peri care and after urination and bowel movements.

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In the past, care givers have adhered to the usual night time incontinence routine: Check and change every 2 hours. And, in the past, it was considered poor care to allow an absorbent product to be worn after a urinary void.

At night, care givers are still responsible for turning patients and making sure they are clean and dry. But what about their sleep habits? Many times patients request care givers to stop waking them for this routine care. Hence the dilemma: How can we provide appropriate care while allowing people to sleep?

The literature tells us that sleep has a powerful restorative purpose, and that lack of sleep disrupts many daytime functions. Studies also indicate that lack of proper REM and non-REM sleep leads to a disruption of both mental and physical recovery.

Today’s absorbent products for urinary incontinence contain polymer, a substance that absorbs urine, taking it out of the liquid state. Briefs are available specifically for night time use contain polymer sufficient to withstand numerous voids for a 6-8 hour period. Even for those whose urinary output is high, night time briefs will continue to absorb void after void.

To promote healthy sleep, try standing quietly near the bed to assess if your patient is asleep and breathing quietly. For those who need turning, do so gently. Don’t turn the lights on. For those who are heavily incontinent, choose a regular or night time brief. Allow the brief to stay in place 6-8 hours unless there has been a stool. If a BM occurs, change the brief and perform peri care.

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People who have urinary or fecal (bowel) incontinence are at greater risk for skin irritation, ulcers, and infection. This is because the skin is exposed to prolonged moisture from the urinary and/or fecal incontinence.

It is essential to provide thorough cleaning of the incontinent area with each episode.

• Cleanse perineal skin daily and after each major incontinence episode using a no-rinse cleanser
• Avoid scrubbing the skin; use a soft or disposable washcloth or pre moistened disposable wipe
• Apply an appropriate moisturizer (often a cream product containing humectant and emollient)
• Apply a skin protectant to minimize contact between urine and/or stool (ointment containing petrolatum, zinc oxide, dimethicone, or combination of these products)
• Combine steps using a product containing a cleanser plus a moisturizer with or without a skin protectant

If the incontinent individual requires the use of a disposable product to control the incontinence, utilize a high quality absorbent product and change the product when it becomes wet and/or soiled.

Caregivers should examine the skin often to evaluate the condition of the skin and report any signs or symptoms of infection, areas that are not healing or pressure sore areas to the physician for further guidance and treatment recommendations.

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