Individuals who suffer with incontinence, especially in relation to faeces, will often be at risk of skin breakdown and develop incontinence-associated dermatitis (IAD) which, if left untreated, can lead to pressure ulcer formation ( Gray, 2004 ). IAD is caused by increased, unrelieved moisture against the skin, usually from liquid faeces and urine, which can then weaken the skin integrity. The integrity of the skin in this area is also at risk of pressure ulcers caused by shear or friction ( Beeckman et al, 2010a ). Treatment and prevention of IAD lesions involves a three-step process used in post-incontinence episodes, which includes cleansing, moisturisation and protection of the skin ( Beeckman et al, 2011a ). Using a wipe covers all of these steps immediately following incontinence episodes ( Rönner et al, 2010 ). This reduces the need to gather a number of different items required for post-incontinence skin care, which usually includes a dry wipe to be soaked in soapy water to wash the skin, a moisturiser to replace lost moisture and a skin protectant to prevent moisture from direct contact with the skin ( Foxley and Baadjies, 2009 ). This article will give some examples of the use of a particular continence and cleansing wipe in clinical practice.
Evidence-based patient care for those with urinary and faecal incontinence involves routine tasks that are integral to essential patient care. However, over the past few decades, researchers have demonstrated how ritualistic practice in this area has become. There is also a growing range of skin care products that can be used to prevent incontinence-associated dermatitis and for nurses, deciding which ones to use can be problematic Incontinent patients have a 22% higher risk of developing pressure ulcers - when immobile this risk increases to 30% - and the often indiscriminate use of various lotions, without a significant evidence base, is a growing cause of concern. Maintaining healthy skin for those patients who have a spinal cord injury and also experience urinary and faecal incontinence is a challenge faced by nurses in primary and secondary care. Research undertaken in secondary care demonstrates that standardization to an evidence-based skin care regime, to be used after incontinent episodes, improves patient care in this specialist area.
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