Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Exp Dermatol. 2024 Nov;33(11):e70013. doi: 10.1111/exd.70013.
Incontinence-associated dermatitis (IAD) is one of the most serious complications in older people with incontinence. Controlling urine property in absorbent pads could be effective for preventing IAD caused by bacterial urine. However, no animal model has been established to evaluate their effectiveness. This study aimed to induce IAD-like skin changes using absorbent pads containing bacterial urine and to confirm their pathophysiology in rats. Hairless Wistar Yagi rats were divided into the bacteria-containing urine (BU) and the bacteria-free urine (U) groups. A 10-h-attachment of absorbent pads containing artificial urine with/without bacteria to the skin pretreated with sodium lauryl sulfate was performed repeatedly for 5 days. Macroscopic findings and skin barrier function were examined every day, and histological changes, inflammatory responses and bacterial quantification in tissue samples were examined on Day 5. The BU group exhibited significant skin redness from Day 3, significant elevation of transepidermal water loss from Day 1, and histological changes, including significantly thickened epidermis, abnormal keratinocyte differentiation and erythrocyte leakage. Inflammation, confirmed by higher myeloperoxidase-positive cells, elevated tumour necrosis factor-α expression, and vascular endothelial damage, indicated by CD31 and pentraxin 3-positive cells, were observed in the BU group. The bacterial quantification showed no significant difference between the groups. IAD-like skin changes including histological changes and inflammation were suggested to be caused by urine properties altered by bacteria. This study proposed a new animal model for evaluating the effectiveness of absorbent pads in controlling the urine properties of bacterial urine on preventing IAD.
失禁相关性皮炎（IAD）是失禁老年人最严重的并发症之一。控制吸收垫中的尿液特性可能对预防由细菌尿液引起的 IAD 有效。然而，尚未建立评估其有效性的动物模型。本研究旨在使用含有细菌尿液的吸收垫诱导类似于 IAD 的皮肤变化，并在大鼠中确认其病理生理学。无毛 Wistar Yagi 大鼠分为含细菌尿液（BU）组和无细菌尿液（U）组。将含有人工尿液的吸收垫在经硫酸月桂酯预处理的皮肤上附着 10 小时，每天重复 5 天。每天检查宏观发现和皮肤屏障功能，并在第 5 天检查组织样本中的组织学变化、炎症反应和细菌定量。从第 3 天开始，BU 组皮肤出现明显的发红，从第 1 天开始，经表皮水分流失显著升高，组织学变化包括表皮明显增厚、角质形成细胞分化异常和红细胞渗漏。在 BU 组中观察到炎症，通过更高的髓过氧化物酶阳性细胞证实，肿瘤坏死因子-α表达升高，以及通过 CD31 和 pentraxin 3 阳性细胞证实的血管内皮损伤。细菌定量两组之间无显著差异。建议存在类似于 IAD 的皮肤变化，包括组织学变化和炎症，这是由细菌改变尿液特性引起的。本研究提出了一种新的动物模型，用于评估吸收垫控制细菌尿液尿液特性以预防 IAD 的有效性。
