Hôpital C. Celton (APHP), 4 Parvis C. Celton 9, F-2130 Issy les Moulineaux, France.
BMC Geriatr. 2010 Nov 22;10:86. doi: 10.1186/1471-2318-10-86.
Incontinence associated dermatitis (IAD) is an inflammatory skin disease mainly triggered by prolonged skin contact with urine, feces but also liberal detergent use when cleansing the skin. To minimize the epidermal barrier challenge we optimized the design of adult incontinence briefs. In the fluid absorption area we interposed a special type of acidic, curled-type of cellulose between the top sheet in contact with the skin and the absorption core beneath containing the polyacrylate superabsorber. The intention was to minimize disturbance of the already weak acid mantle of aged skin. We also employed air-permeable side panels to minimize skin occlusion and swelling of the stratum corneum.
The surface pH of diapers was measured after repeated wetting with a urine substitute fluid at the level of the top sheet. Occlusive effects and hydration of the stratum corneum were measured after a 4 hour application of different side panel materials by corneometry on human volunteers. Finally, we evaluated skin symptoms in 12 patients with preexisting IAD for 21 days following the institutional switch to the optimized diaper design. Local skin care protocols remained in place unchanged.
The improved design created a surface pH of 4.6 which was stable even after repeated wetting throughout a 5 hour period. The "standard design" briefs had values of 7.1, which is alkaline compared to the acidic surface of normal skin. Side panels made from non-woven material with an air-permeability of more than 1200 l/m2/s avoided excessive hydration of the stratum corneum when compared to the commonly employed air-impermeable plastic films. Resolution of pre-existing IAD skin lesions was noted in 8 out of 12 patients after the switch to the optimized brief design.
An improved design of adult-type briefs can create an acidic pH on the surface and breathable side panels avoid over-hydration of the stratum corneum and occlusion. This may support the epidermal barrier function and may help to reduce the occurrence of IAD.
失禁相关性皮炎（IAD）是一种炎症性皮肤病，主要由尿液、粪便与皮肤长时间接触，以及在清洁皮肤时过度使用清洁剂引起。为了最大程度地减少表皮屏障的挑战，我们优化了成人失禁短裤的设计。在液体吸收区域，我们在与皮肤接触的顶片和含有聚丙烯酸盐高吸水性聚合物的吸收芯之间插入了一种特殊类型的酸性卷曲纤维素。这样做的目的是尽量减少对老年皮肤已经较弱的酸性表层的干扰。我们还采用透气侧片来减少角质层的闭塞和肿胀。
在顶片水平上，用尿液替代液反复润湿后，测量尿布的表面 pH 值。通过对人体志愿者进行 4 小时的不同侧片材料应用的角质层测量，测量闭塞效应和角质层的水合作用。最后，我们在 12 名患有预先存在的 IAD 的患者中进行了评估，在机构切换到优化的尿布设计后 21 天内评估皮肤症状。局部皮肤护理方案保持不变。
改良设计创造了 4.6 的表面 pH 值，即使在 5 小时的反复润湿过程中也保持稳定。“标准设计”短裤的 pH 值为 7.1，与正常皮肤的酸性表面相比呈碱性。与常用的不透气塑料薄膜相比，透气性超过 1200 l/m2/s 的非织造材料制成的侧片可避免角质层过度水合。在切换到优化的短裤设计后，12 名患者中有 8 名的预先存在的 IAD 皮肤病变得到缓解。
成人型短裤的改良设计可以在表面产生酸性 pH 值，透气侧片可避免角质层过度水合和闭塞。这可能有助于支持表皮屏障功能，并有助于减少 IAD 的发生。
