Incontinence Associated Dermatitis

Incontinence Associated Dermatitis

Prevalence and associated risk factors for Incontinence Associated Dermatitis

Incontinence associated dermatitis (IAD) is moisture related skin damage that occurs when urine or stool comes into contact with perineal or perigenital skin.1 Often painful, it can affect a patient’s physical and psychological well-being.

While much research has been done, there are still knowledge gaps regarding: different assessment methods, differences in the type of associated incontinence, and different care settings.

That’s why a recent study conducted secondary data analysis of three consecutive annual studies comprising 5,785 residents of 78 German nursing homes.2 Their IAD was gauged using the Incontinence-Associated Dermatitis Intervention Tool-D, (IADT-D) a German language version. “This instrument differentiates severity of IAD and classifies individuals as at high risk for IAD (yes/no), or as having IAD (early, moderate, severe) and as having a concurrent fungal-appearing rash (yes/no).” The authors noted the German version demonstrated high content validity and high inter-rater reliability. 2

The study reported the prevalence of IAD among the 5,785 patients as follows: 66.8% had urinary incontinence, 38.1 % had fecal incontinence, and 36.6% had both types of incontinence.2 It also tabulated the characteristic risk factors of incontinent patients, with and without IAD.

Overall, the study found a higher percentage of patients with IAD had the following risk factors: 1) fecal incontinence, 2) double incontinence, 3) female, 4) higher BMI, 5) pressure injuries. The authors reported that these fi ndings are mostly consistent with other studies noted. They also found, “The IADT-D seems an adequate instrument to detect levels of severity of IAD as well as risk for IAD.” 2

While more study is needed to verify all associated factors for IAD, knowledge of these potential risks should be integrated into all patient care, paying special attention to skin protection measures.

1 Gray, M. et al. (2007) Incontinence-associated dermatitis: a consensus. Journal of Wound, Ostomy and Continence Nursing. 34(1) 45-54. 2 Boronat-Garrido, X. et al. (2016) Incontinence-Associated Dermatitis in Nursing Homes. Journal of Wound, Ostomy and Continence Nursing. 43(6) 630-635.

For more information on the assessment, prevention and management of Incontinence Associated Dermatitis, check out these articles:

Incontinence Associated Dermatitis in the Elderly Patient – Aging Life Care Association™
What Is Incontinence-Associated Dermatitis and How Is It Treated? – Healthline Media