Incontinence Care

Holly M. Hovan MSN, APRN, GERO-BC, CWOCN-AP

Moisture-associated skin damage (MASD) is sometimes accompanied by serous exudate, a denuded appearance of skin, or a secondary cutaneous infection. As the most common form of MASD, incontinence-associated dermatitis (IAD) is characterized by erythema and edema of the skin’s surface. IAD is a top-down injury, often presenting with inflammation, erosion, or denudation in the setting of fecal or urinary incontinence.

By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Moisture-associated skin damage (MASD) is becoming increasingly prevalent in today’s health care system. Often associated with discomfort and pain, MASD ultimately negatively impacts quality of life. MASD is usually broken down into 3 or 4 categories, most commonly incontinence-associated dermatitis (IAD), intertriginous dermatitis, periwound dermatitis, and peristomal dermatitis. In this blog, I focus on the prevention and treatment of IAD and subsequent pressure injuries in critical care through a nurse-led approach.

Elizabeth Day Dechant, BSN, RN, CWOCN, CFCN

Diaper rash, more officially known as incontinence-associated dermatitis (IAD), affects hospitalized and incontinent patients of all ages. In my years as a WOC Nurse in a pediatric hospital, IAD has been by far the most frequently treated condition. However, outside of a health care setting, IAD is the most common skin problem in infants and young children who are not yet toilet trained. Diaper rash has plagued babies and new parents for centuries, yet its treatment remains highly debated. For the purpose of this article, I am focusing on the prevention and treatment of diaper rashes in infants and young children, although the principles of topical treatment discussed here apply to all patients.

By Cheryl Carver, LPN, WCC, CWCA, MAPWCA, FACCWS

Many of us will eventually take on a caregiver role in one form or another. According to the 2020 update, the number of family caregivers in the United States increased by 9.5 million between 2015 and 2020. More than one in every five Americans is now a caregiver in their own home. Because of our aging population, there is an associated increase in demand for caregiving, and there should be an emphasis on education and support for this population.

by Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

The literature suggests that patients with a high degree of adiposity are more at risk for inflammatory conditions, and the numbers of these patients continue to rise. Increased adipose tissue may impact activities of daily living, continence, and overall quality of life (QoL), among other complications. Abdominal (central) obesity may be associated with incontinence, mechanical and neurogenic changes (chronic strain or weakening of nerves in the pelvic area), and skinfold inflammation or irritation.

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.

Absorbent briefs: Briefs used to absorb urine and stool and to help prevent moisture-associated skin damage in patients with incontinence issues. Briefs with high breathability and wicking help to maintain the skin microclimate.

Barrier products: Creams, sprays, wipes, or other products used to seal the skin and protect it from breakdown caused by moisture or incontinence.

Cyanoacrylates: A skin sealant that bonds to the skin surface and integrates with the epidermis. Cyanoacrylates are strong and resistant to washing off.

By Joy Hooper RN, BSN, CWOCN

Some people choose the J-Pouch procedure rather than the traditional colostomy or ileostomy.

By Joy Hooper RN, BSN, CWOCN

The "J-Pouch" is an example of an internal intestinal pouch constructed of small intestine. The surgery is performed as an alternative to a permanent ileostomy when the large intestine (colon) needs to be removed. The J-Pouch procedure can be performed in a I, II, or III stage surgical procedure. Although there are many complications associated with this procedure such as anal leakage after surgery, bowel obstruction, and pouchitis, there are many people that feel the J-Pouch procedure literally gave them their life back. Below is a comment from a J-Pouch patient: