Nurses care for many patients who suffer from Incontinence Dermatitis. Did you know that Incontinence Dermatitis is often mistaken for a pressure injury? Incontinence Dermatitis has’ different aetiologies from a pressure injury but the two can be present at the same time. Incontinence Dermatitis known as a ‘top down’ condition – damage commences on the surface of the skin. A pressure injury develops when damage is commenced with changes in the soft tissue below and within the skin and it is known as a ‘bottom-up’ injury.
Cause of Incontinence Dermatitis
Incontinence Dermatitis is related to a ‘moisture/overhydration + additional insult’ phenomenon. ‘Exposure to urine and/or faeces initially causes over-hydration of the skin, which does not usually cause skin breakdown. It does cause reduced tensile strength and cause an elevated pH.
The reduction in tensile strength makes the person’s skin more susceptible to mechanical damage from friction and shear, and the altered pH makes it more susceptible to invasion by microorganisms
Did you know the altered pH can also activate faecal enzymes, which can cause direct damage to the epidermis.
The over-hydration acts to ‘set the skin up’ and it is the secondary factors (friction, shear, enzymatic damage and invasion by microorganisms) that cause skin loss and infection.
Circumstances that Increase the Risk of Incontinence Dermatitis
Faecal incontinence (diarrhoea/formed stool)
Double incontinence (faecal and urinary)
Frequent episodes of incontinence (especially faecal)
Use of occlusive containment products
Poor skin condition
Diminished cognitive awareness Poor personal hygiene
Poor personal hygiene
Medication (antibiotics, immunosuppressants)
There are some valuable Nursing tips to use when caring for those with Incontinence Dermatitis. We have created a good info sheet that you can download which identifies 6 internationally supported Nursing Tips. Download it and pop it up in your workplace as a reminder!
The Nurses for Nurses Network provides great information and CPD on an array of nursing topics including wound care in a range of easy learning ways including webinars and quizzes on the latest information that Nurses need to know – remember the Nurses for Nurses Network was created by Australian Nurses for Nurses! www.nursesfornurses.com.au
Reference: Ousey K, O’Connor L, Doughty D, Hill R, Woo K. Incontinence-associated dermatitis Made Easy. London: Wounds International 2017; 8(2). Available from: www.woundsinternational.com