The effect of 2 different care products on incontinence-associated dermatitis in patients with fecal incontinence

Abstract

Purpose: We compared the effects of 2 devices used to contain fecal incontinence--a perianal pouch and adult containment brief--on the incidence of incontinence-associated dermatitis (IAD).

Design: Randomized controlled trial.

Subjects and setting: The sample was drawn from patients hospitalized in the neurology and neurosurgery wards of a large university hospital in Turkey. Thirty bedridden subjects with fecal incontinence and indwelling urinary catheters participated in the study. Subjects were randomly allocated to treatment with a perianal pouch (n = 15) or adult containment brief (n = 15).

Methods: Routine hygiene was completed once daily and repeated whenever the perineal area was found to be soiled.Perineal skin integrity was evaluated daily during skin care. Data were collected using a Patient Identification Form, a Patient Observation Form, and a Perineal Skin Integrity Assessment Form.

Results: The mean number of products used on a daily basis by patients with a perianal pouch was 5.80, as compared to 5.46 by patients with adult incontinence briefs. IAD occurred in 66.7%of patients in the perianal pouch group and in 100% of subjects managed by containment briefs, a statistically significant difference (χ² = 6.0, P = 0.04). The onset of IAD occurred later in subjects allocated to management with a perianal pouch than inpatients using adult containment briefs (U = 30.500, P = 0.011). IAD involved an average of 1.8 areas among patients managed with a perianal pouch, as compared to 2.3 areas in patients managed with adult containment briefs (P = NS).

Conclusion: Management of bedridden patients with fecal incontinence with a perianal pouch reduced the incidence of IAD and delayed to time to onset when compared to management with adult containment briefs. We recommend use of perianal pouches for prevention of IAD in bedridden patients with fecal incontinence.