Barrier products in the treatment of incontinence-associated dermatitis

Abstract

This article reviews contemporary primary research studies to establish the evidence supporting the use of barrier products and evaluate practice regarding their use in the acute hospital setting. Six primary research studies investigating the use of barrier products for preventing and managing incontinence-associated dermatitis were reviewed. The aim was to identify the most effective treatments for incontinence-associated dermatitis to enhance the quality of life of patients. The studies identified that there is no significant difference in efficacy between petrolatum, zinc oxide oil and a polymer-based barrier film, and that a polymer-based barrier film is more cost-effective than petrolatum or zinc oxide. However, further robust research studies are required to inform practice. The efficacy and cost-effectiveness of barrier products can be enhanced by providing education in clinical practice on consistent skin care regimens and effective use of barrier products.

Comparing the Efficacy of Zinc Oxide Versus Barrier Creams for Pressure Injury Prevention: A Retrospective Cross-sectional Study

“…At the end of the study, a significantly higher number of participants in the Calmoseptine group as compared with the Desitin group completely recovered on day 6, and there was a greater reduction in the affected area on all the follow-up days 30 . Similarly, Lian 31 examined the use of barrier products to prevent and manage incontinence-associated dermatitis and found that there was no significant difference in efficacy between petrolatum, zinc oxide oil, and polymer-based barrier film and that polymer-based barrier film was more cost-effective than petrolatum or zinc oxide.…”

Specific dermatological benefits associated with quantities of lotion transferred to the skin

“…Once saturated, the skin is more susceptible to damage caused by friction and shearing forces that can contribute further to irritation. Overhydration of the skin is a known contributing factor in the development of diaper or incontinence dermatitis, and the use of barrier cream products is an accepted element in preventing these conditions …”

“…Overhydration of the skin is a known contributing factor in the development of diaper or incontinence dermatitis, 7,9 and the use of barrier cream products is an accepted element in preventing these conditions. 30,31 In our studies, test sites were pretreated with lotion to evaluate the concentration of lotion required to provide protection from overhydration when wetted absorbent products were applied subsequently under occlusive conditions (Figure 4). Results show that concentrations as low as 70-80 lg/cm 2 protected test sites from overhydration based on a significantly lower TEWL compared to control sites not treated with lotion.…”

Moisture-Associated Skin Damage

“…The topical application of a skin protectant (also called a skin barrier) is suitable for most patients. Skin protectants come in a variety of formulations and applications including creams, pastes, films, sprays, skin cleansers and wipes, etc 96–98. Healing of damaged skin may involve replenishing moisture or lipids using topical products such as a moisturizer, humectant, or emollient 96,99…”