Wound Care Made Incredibly Easy

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External threats to skin integrity

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Product

Purpose

Comparison

Tips

It is best to use super-absorbent briefs for ambulation or while up in a chair and use super-absorbent underpads when the patient is in bed to allow airflow to the skin. Some briefs keep the skin more acidic, which maintains a better barrier func tion. Dignity Compose, Dignity Comfort, and Dignity Complete from Hartmann are briefs with “curly fibers” that help keep the skin’s pH acidic.

Absorptive products

To quickly wick away urine into an inner core and away from the skin

Some types of absorp tive briefs and underpads may not be able to trap liquid in the core, so they often include a plastic

layer, which further traps moisture and is counterproductive.

IAD has a close association with the development of pressure in juries. Anything that damages skin integrity causes an increased risk of pressure-related injuries. An analysis of an international database of 176,689 patients showed that for those who had incontinence (92,889), 16.3% had pressure injuries in the affected areas; those who did not have incontinence had a 4.1% prevalence (Lachenbruch et al., 2016). A data analysis of 5,342 patients published in 2018 showed that the presence of incontinence-related skin damage (odds ratio [OR] 4.56) and immobility (OR 3.56) was associated with signifi cantly increased likelihood of developing full-thickness sacral pressure injury (Gray & Guiliano, 2018). The OR for IAD was even higher than for immobility! This is one area of health care in which an ounce of prevention is worth a pound of cure. It is essential to develop a plan for prevention and treatment and then stick to it. One simple method is the Incontinence-Associated Dermatitis In tervention Tool© (IADIT©), meant to give bedside caregivers including family a simple way to match level of risk or skin injury to interven tions that may help. This is reprinted here with permission from the author Joan Junkin. It has been translated into several languages to be used in research and education. The German translation (IADIT-D) was used in a long-term care study and was found to have high or very high interrater reliability among 19 assessors of level of severity of IAD due to incontinence (Braunschmidt et al., 2013). Another simple method to classify IAD is the Ghent Global IAD Categorisation Tool (GLOBIAD). There is a revision of this tool There are several methods of classifying the damage to skin associated with incontinence that range from simple to complex.

Classifying IAD

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