Ichikawa-Shigeta Y, Sugama J, Sanada H, Nakatani T, Konya C, Nakagami G, Minematsu T, Yusuf S, Mugita Y
J Wound Care. 2014 Jan;23(1):18-9, 22-23, 26 passim. doi: 10.12968/jowc.2014.23.1.18.
To identify the physiological and appearance characteristics of skin maceration caused by urine and/or faeces and determine their suitability as risk indicators for incontinence-associated dermatitis.
This cross-sectional, comparative study involved sixty-nine elderly women with urinary and/or faecal incontinence who provided informed consent to participate. Exclusion criteria included serious medical problems, acute illness and the presence of damaged skin on the buttocks. The physiological and appearance characteristics of macerated skin on the buttocks of the patients were examined. Stratum corneum and dermis hydration levels, transepidermal water loss and skin pH were used to assess skin condition. Skin morphology (sulcus cutis) was confirmed using images at x15 magnification. The erythema index and white index were used to evaluate colour in the macerated skin areas.
Forty-four patients exhibited skin maceration. Stratum corneum and dermis hydration levels were significantly greater in the maceration group than in the non-maceration group, as were transepidermal water loss, skin pH and differences in sulcus cutis interval between the buttock of interest and the subumbilical region. Furthermore, differences in the erythema and white indices between these two regions were significantly higher and lower, respectively, in the maceration group than in the non-maceration group.
To our knowledge, this is the first report to note that there are interesting changes not only in the epidermal layer but also in the dermis layer in patients with skin maceration. This finding confirmed that skin maceration caused by incontinence is a severe condition. Moreover, the erythema index was the best index for identifying skin maceration caused by incontinence, indicating that it can be used for precise and easy identification of the condition in clinical practice.
识别由尿液和/或粪便引起的皮肤浸渍的生理和外观特征，并确定其作为失禁相关性皮炎风险指标的适用性。
这项横断面比较研究纳入了69名患有尿失禁和/或粪失禁且提供知情同意书参与研究的老年女性。排除标准包括严重的医疗问题、急性疾病以及臀部皮肤受损。对患者臀部浸渍皮肤的生理和外观特征进行检查。角质层和真皮的水合水平、经表皮水分流失和皮肤pH值用于评估皮肤状况。使用放大15倍的图像确认皮肤形态（皮肤沟）。红斑指数和白色指数用于评估浸渍皮肤区域的颜色。
44名患者出现皮肤浸渍。浸渍组的角质层和真皮水合水平显著高于非浸渍组，经表皮水分流失、皮肤pH值以及患侧臀部与脐下区域之间的皮肤沟间隔差异也是如此。此外，浸渍组这两个区域之间的红斑指数差异显著高于非浸渍组，而白色指数差异则显著低于非浸渍组。
据我们所知，这是第一份指出皮肤浸渍患者不仅表皮层而且真皮层都有有趣变化的报告。这一发现证实失禁引起的皮肤浸渍是一种严重情况。此外，红斑指数是识别失禁引起的皮肤浸渍的最佳指标，表明它可用于临床实践中对该病症进行精确且简便的识别。
