Presentation on theme: "K Lenne USL Medical 2012. Maintenance of healthy, intact perineal skin constant challenge when caring for incontinent people Urinary and faecal incontinence."— Presentation transcript:
Maintenance of healthy, intact perineal skin constant challenge when caring for incontinent people Urinary and faecal incontinence can have devastating effect on the skin of an individual regardless of age In severe cases skin is so badly damaged that a moisture lesion or pressure ulcer can develop
42% incontinence sufferers skin conditions (IAD) Long term use pads frequently results in IAD in otherwise healthy skin 7% 65 yrs+ affected FI Long term elderly care 66% FI 1 in 4 in residential care Ageing population FI increase Major implications for patients + health system
Complex cascade events involving attack of skin by physical, chemical, enzymatic and microbial factors. Moisture, physical irritants, chemical irritants, faecal enzymes, ph and microbes all play a roll in the downward cycle of events.
Moisture Excessive moisture from urine, sweat + frequent washing increases friction - rubbing against pads Skin overhydrated + stratum corneum swells - more permeable to microbial growth Physical and chemical irritants Frequent washing significant source of both to skin Soaps and cleansers- most contain surfactants to lower skin surface tension making it easier to loosen + wash away contaminants Ph often very alkaline
Stool, enzymes and pH Proteolytic and liptolytic enzymes deactivated GT Faeces + urea mix and release ammonia Shifts acid mantle skin towards alkalinity This alkaline ph reactivates the digestive enzymes If barrier function compromised more likely to be attacked by bacteria 60% faecal matter comprised bacteria 4–500 species micro organisms These pathogens destroy epidermal layer Bacteria, yeast + fungus invade Skin taut, painful, erythematous IAD
Vicious feedback cycle results in IAD If person’s condition further compromised by pressure, poor nutrition or disease, major breakdown can easily occur Quality of life is of primary importance Add in cost of treating PU can range 5-40k Advantageous to invest in good skin care regime rather than treat resulting breakdown
Impaired acid protection mantle Diminished lipid production Diminished sweating Reduced regeneration potential Ability to fight bacteria + fungi weakened In a nutshell often malnourished, slow to regenerate and the affects of incontinence stress skin further
Skin cleansed asap after every episode FI No soap as cleanser – already dry skin Soap astringent effect (alkaline ph) dries skin further Soap also has surfactants which act as irritants, cause further damage If not rinsed off skin completely damage continues Even water removes acid protection mantle short term No rinse skin cleansers better – mild, gentle surfactant, soothing Emulsify and loosen faeces to cleanse skin- no rubbing
PH balance to strengthen acid protection mantle Replenish moisturising substances Support skin’s own lipid production Speed up skin’s reproduction Most products cleanse, moisturise and protect Hartmann’s Menalind also focus on REGENERATION
Skin affected by FI may require extra protection and nutritional support for regeneration. Products used must : provide optimum protection without inhibiting the absorption capacity of incontinence products NO ZINC + CASTOR OIL, FATTY CREAMS in pad area
Support epidermal barrier function Strengthen acid mantle protection Replenish moisturising substances Support skin’s own lipid production Help to speed up skin’s reproduction Remove and reapply after each episode FI Creams must be water based Liquid films contain polymer + solvent If skin already compromised film may irritate dermis
Provide superior leakage protection Rapid fluid absorption and safe storage Keep skin dry and prevent stratum corneum swelling Reduce ammonia production Stabilise ph skin - support skin’s antibacterial effect Maintain healthy skin temperature
Minimise episodes FI Select right continence product that provides superior leakage protection while helping to prevent IAD Ensure skin cleansing regimes ASAP after every episode FI Protect at risk skin from damage Prevent skin damage that so easily can lead to pressure ulcers or moisture lesions Prevention better than cure
Your consent to our cookies if you continue to use this website.