University of Virginia Department of Urology and School of Nursing, Charlottesville, VA, USA.
J Wound Ostomy Continence Nurs. 2012 Jan-Feb;39(1):61-74. doi: 10.1097/WON.0b013e31823fe246.
In 2009, a multinational group of clinicians was charged with reviewing and evaluating the research base pertaining to incontinence-associated dermatitis (IAD) and synthesizing this knowledge into best practice recommendations based on existing evidence. This is the first of 2 articles focusing on IAD; it updates current research and identifies persistent gaps in our knowledge. Our literature review revealed a small but growing body of evidence that provides additional insight into the epidemiology, etiology, and pathophysiology of IAD when compared to the review generated by the first IAD consensus group convened 5 years earlier. We identified research supporting the use of a defined skin care regimen based on principles of gentle perineal cleansing, moisturization, and application of a skin protectant. Clinical experience also supports application of an antifungal powder, ointment, or cream in patients with evidence of cutaneous candidiasis, aggressive containment of urinary or fecal incontinence, and highly selective use of a mild topical anti-inflammatory product in selected cases. The panel concluded that research remains limited and additional studies are urgently needed to enhance our understanding of IAD and to establish evidence-based protocols for its prevention and treatment.
2009 年,一组多国临床医生负责审查和评估与失禁相关性皮炎(IAD)相关的研究基础,并根据现有证据将这些知识综合为最佳实践建议。这是两篇专注于 IAD 的文章中的第一篇,它更新了当前的研究,并确定了我们知识中的持续存在的差距。我们的文献综述显示,与 5 年前召集的第一组 IAD 共识小组生成的综述相比,当涉及到 IAD 的流行病学、病因和发病机制时,有少量但不断增加的证据提供了更多的见解。我们确定了支持基于温和会阴清洁、保湿和应用皮肤保护剂的特定皮肤护理方案的研究。临床经验还支持在有皮肤假丝酵母菌病证据的患者中应用抗真菌粉、软膏或乳膏,积极控制尿失禁或粪便失禁,并在选定病例中高度选择性地使用温和的局部抗炎产品。专家组得出结论,研究仍然有限,迫切需要进一步研究,以提高我们对 IAD 的理解,并为其预防和治疗建立基于证据的方案。