Objectives: To evaluate the effectiveness of zinc oxide (ZnO) ointments versus non-irritant barrier films (NIBFs) in the prevention of Incontinence-Associated Dermatitis (IAD). Specific objectives included analyzing the effects of treatment over time, establishing when IAD appears in each group, and determining the safety and cost-effectiveness of both treatments. Methodology: A multicenter prospective cohort study was carried out in 10 social health centers in Spain. The final sample included 164 older institutionalized patients with urinary and/or mixed incontinence, divided into two cohorts (79 with ZnO and 85 with NIBF). Follow-up lasted for six weeks. Validated scales were used for data collection, such as the Categorization of Moisture-Associated Skin Damage (MASD) of the GNEAUPP (National [Spain] group for the assessment of pressure ulcers and chronic wounds) and the Visual Erythema Scale (VES). Results: The overall incidence of IAD was 20.7% in the sample during follow-up. No statistically significant difference in effectiveness was found between ZnO (27.8% incidence of IAD) and NIBF (32.9% incidence of IAD) in preventing IAD (p = 0.479). However, survival analysis suggested that the onset of IAD is delayed more in the NIBF group. No adverse events or side effects were reported attributable solely to the use of the products. When considering the total cost per process (including staff application time), ZnO ointment was EUR 0.02 more expensive per patient per day than NIBFs. Conclusions: Although both products have similar efficacy and safety, NIBFs delay the onset of IAD more than ZnO. In addition, despite a higher unit price, NIBFs are more cost-effective per procedure because of savings in nursing time during application and removal.
Objectives: To evaluate the effectiveness of zinc oxide (ZnO) ointments versus non-irritant barrier films (NIBFs) in the prevention of Incontinence-Associated Dermatitis (IAD). Specific objectives included analyzing the effects of treatment over time, establishing when IAD appears in each group, and determining the safety and cost-effectiveness of both treatments. Methodology: A multicenter prospective cohort study was carried out in 10 social health centers in Spain. The final sample included 164 older institutionalized patients with urinary and/or mixed incontinence, divided into two cohorts (79 with ZnO and 85 with NIBF). Follow-up lasted for six weeks. Validated scales were used for data collection, such as the Categorization of Moisture-Associated Skin Damage (MASD) of the GNEAUPP (National [Spain] group for the assessment of pressure ulcers and chronic wounds) and the Visual Erythema Scale (VES). Results: The overall incidence of IAD was 20.7% in the sample during follow-up. No statistically significant difference in effectiveness was found between ZnO (27.8% incidence of IAD) and NIBF (32.9% incidence of IAD) in preventing IAD (p=0.479). However, survival analysis suggested that the onset of IAD is delayed more in the NIBF group. No adverse events or side effects were reported attributable solely to the use of the products. When considering the total cost per process (including staff application time), ZnO ointment was €0.06 more expensive per patient per day than NIBFs. Conclusions: Although both products have similar efficacy and safety, NIBFs delay the onset of IAD more than ZnO. In addition, despite a higher unit price, NIBFs are more cost-effective per procedure because of savings in nursing time during application and removal.
Objectives: The general objective of the study was to analyze the influence of sociodemographic factors and care and hygiene practices on the appearance of Incontinence-Associated Dermatitis (IAD). The specific objectives were to identify the relationship between sociodemographic variables (age, sex, comorbidities) and the incidence of IAD, and to evaluate hygiene protocols (cleaning products and absorbent use and practices) and compare time to IAD onset according to the hygiene practices used. Methods: A multicenter, prospective cohort study was conducted across 10 social health centers. The study population consisted of older institutionalized patients with urinary and/or mixed incontinence who used absorbents continuously. The variables included risk assessment using validated scales, such as the Braden scale and the Perianal Assessment Tool (PAT), as well as ad hoc questionnaires. Survival analysis of time-to-event onset was assessed using the Kaplan–Meier curve and the Log-Rank test. Results: A statistically significant association was found between the occurrence of IAD and the Braden scale (p = 0.004) and the PAT scale (p = 0.02). However, no statistically significant association was found with age, sex, or the Barthel Index. Regarding hygiene, soapy wipes were associated with the highest incidence of IAD. In contrast, dry wipes were the most effective, with the lowest cumulative risk and the longest time-to-event (p = 0.001). The brand of the absorbent used had a significant influence (p = 0.024), suggesting that the “B” brand prevented one IAD per six patients compared with the “A” brand. The frequency of absorbent changes did not show a statistically significant association. Conclusions: The risk of developing IAD was strongly linked to the scores of the Braden and PAT scales, the brand of the absorbent (“B” being more effective), and the cleaning product used, with dry wipes being the most protective compared to soapy wipes. On the other hand, factors such as age, sex, degree of dependence (Barthel), or frequency of absorbent change did not show a significant influence on the appearance of IAD.
Objectives: The general objective of the study was to analyze the influence of sociodemographic factors and care and hygiene practices on the appearance of Incontinence-Associated Dermatitis (IAD). The specific objectives sought to identify the relationship between sociodemographic variables (age, sex, comorbidities) and incidence of IAD, to evaluate hygiene protocols (cleaning products and absorbent handling), and to compare the time of onset of IAD according to the input used. Methods: A multicenter, prospective cohort study was conducted across 10 social health centers. The study population consisted of older institutionalized patients with urinary and/or mixed incontinence who used absorbents continuously. The variables included risk assessment using validated scales, such as the Braden Scale and the Perianal Assessment Tool (PAT), as well as ad hoc questionnaires. Survival analysis to assess the time-to-event onset was performed using the Kaplan-Meier curve and the Log-Rank test. Results: A statistically significant relationship was found between the occurrence of IAD and the risk detected by the Braden scale (p=0.004) and the PAT scale (p=0.02). However, no statistically significant relationship was found with age, sex, or the Barthel Index. Regarding hygiene, soapy wipes were associated with the highest incidence of IAD, while dry wipes were the most effective method, with the lowest cumulative risk and the longest time-to-event (p=0.001). The absorbent brand had a significant influence (p=0.024), suggesting that the "B" brand prevented one injury per six patients compared with the "A" brand. The frequency of absorbent changes did not show a statistically significant association. Conclusions: The risk of developing IAD is strongly linked to the scores of the Braden and PAT scales, the brand of the absorbent ("B" being more effective), and the hygiene method, where dry wipes were found to be the most protective against soapy ones. On the other hand, factors such as age, sex, degree of dependence (Barthel), or frequency of change of the absorbent did not show a significant influence on the appearance of the lesion.