Department of Chemistry, University of Bath, Bath, UK.
Watercress Research Ltd., Exeter, UK.
Proc Inst Mech Eng H. 2024 Jun;238(6):655-666. doi: 10.1177/09544119231159178. Epub 2023 Mar 7.
In this review, current understanding of the prevention and treatment of Incontinence Associated Dermatitis (IAD) is discussed. The need for preventative measures which target specific faecal/urinary irritants is highlighted, including the role of urease inhibitors. There is no existing internationally and clinically accepted method to diagnose and categorise the severity of IAD. Diagnosis currently relies on visual inspection; non-invasive techniques to assess skin barrier function could remove subjectiveness, particularly in darker skin tones. Impedance spectroscopy is a non-invasive technique which can be used to monitor skin barrier function, supporting visual assessments. Six studies (2003-2021) which used impedance to assess dermatitis were reviewed; inflamed skin was distinguishable from healthy skin in each case. This suggests that impedance spectroscopy could be useful in diagnosis early-stage IAD, potentially enabling earlier intervention. Finally, the authors present their initial findings on the role of urease in skin breakdown in an IAD model, using impedance spectroscopy.
本综述讨论了目前对失禁相关性皮炎(IAD)的预防和治疗的理解。强调了针对特定粪便/尿液刺激物的预防措施的必要性,包括尿酶抑制剂的作用。目前,尚无国际和临床公认的方法来诊断和分类 IAD 的严重程度。目前的诊断依赖于目视检查;评估皮肤屏障功能的非侵入性技术可以消除主观性,特别是在较深肤色的人群中。阻抗谱是一种非侵入性技术,可用于监测皮肤屏障功能,支持视觉评估。综述了六项研究(2003-2021 年),这些研究使用阻抗来评估皮炎;在每种情况下,发炎的皮肤与健康皮肤都有区别。这表明阻抗谱可能有助于早期诊断 IAD,从而可能更早地进行干预。最后,作者介绍了他们在使用阻抗谱的 IAD 模型中关于尿酶在皮肤破裂中的作用的初步发现。