Urinary incontinence is a relatively common condition marked by loss of control of the bladder. In severe cases, it can have a detrimental impact on the quality of life of patients with this condition. Because of the sensitive and embarrassing nature of the topic, urinary incontinence tends to be underreported.1 There are multiple risk factors for urinary incontinence, including2:
Similar to urinary incontinence, fecal incontinence is underreported. It is also closely associated with age and sex. Although it occurs in approximately 8% of all adults, this figure jumps to 15% for those older than 70 years. Vaginal childbirth is also a primary risk factor for fecal incontinence. For men, those who have had previous anal surgery are at an increased risk for the condition. All patients with Crohn’s disease are at a higher risk for developing fecal incontinence.4
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Urinary and fecal incontinence can have a detrimental impact on skin health. Incontinence-associated dermatitis (IAD) is one type of moisture-associated skin damage (MASD). Prolonged exposure to urine or stool can cause inflammation or erosion of the epidermis or stratum corneum skin. Depending on the care setting, the prevalence of IAD can range from 5.2% to 46%.5 Residents in long-term care settings are at greater risk of IAD because they tend to be of advanced age and have incontinence.6 Increased age is another risk factor for IAD because the skin’s ability to act as a moisture barrier degrades over time. Mobility and diminished sensory perception can also contribute to the overall risk of developing IAD.6Incontinence-Associated Dermatitis Versus Pressure Injury IAD and pressure injuries share many risk factors, such as reduced mobility, incontinence, additional linen layers, longer inpatient treatment durations, and increased Braden Scale for Predicting Pressure Sore Risk© scores. Distinguishing IAD from superficial pressure injuries can be clinically challenging.6 Both IAD and pressure injuries are susceptible to infection. IAD is characterized by erythema and edema of the surface of the skin, sometimes accompanied by serous exudate, erosion, or secondary cutaneous infection.5
Managing and treating incontinence and associated IAD can be challenging, particularly for certain patient populations, such as those with Alzheimer’s disease. Management strategies for incontinence reduce the skin’s exposure to urine and stool and thereby decrease the risk of skin damage. Strategies can include7:
Incontinence can have an extremely negative impact on the lives of patients. In addition to embarrassment and challenges with managing the condition, incontinence can cause painful damage to the skin. Managing incontinence is crucial to enhancing the quality of life of these patients and reducing the risk of associated skin problems such as IAD, pressure injuries, and infection.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, HMP Global, its affiliates, or subsidiary companies.