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 Release 21.0, Jan 2008
 
Chapter : ch21. Dermatology Section : Pressure Ulceration
  Skin Changes in an Incontinent Adult (Incontinence Associated Dermatitis) and the Risk of Pressure Ulceration

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Overview :

Urine and/or fecal incontinence in an adult is a risk factor for pressure ulceration. Certain findings can help identify a patient who may benefit from more aggressive management.

 

Factors influencing the skin changes in the incontinent adult:

(1) amount of urine leakage

(2) amount of fecal leakage

(3) prolonged skin exposure to urine and/or feces

(4) mobility

(5) disability for activities of daily living

 

Risk factors for skin ulceration:

(1) development of blanchable erythema, especially if extensive

(2) impaired mobility, especially in patients spending a large amount of time in bed

(3) prolonged exposure to significant moisture

(4) frequent incontinence

 

where:

• Nonblanchable erythema is the first stage for pressure ulceration.

• Blanchable erythema blanches under finger pressure but promptly returns to a reddish hue when the prssure is released.

• An adult diaper can reduce the amount of moisture that the skin is exposed to if it is changed when soiled.

• The type of incontinence will affect which portions of the skin are affected.

 

The presence of blanchable erythema  identified a patient who should be targeted for prevention, especially when other risk factors are present.

 

  References:

Schnelle JF, Adamson GM, et al. Skin disorders and moisture in incontinent nursing home residents: Intervention implications. J Am Geriatric Soc. 1997; 45: 1182-1188.

 

 

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