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1.
J Wound Ostomy Continence Nurs ; 48(6): 545-552, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34781311

RESUMO

PURPOSE: To evaluate the prevalence of incontinence and treatment of incontinence-associated dermatitis (IAD) and associations with outcomes including total cost of care, length of stay (LOS), 30-day readmission, sacral area pressure injuries present on admission and hospital acquired pressure injuries, and progression of all sacral area pressure injuries to a higher stage. DESIGN: Retrospective analysis. SUBJECTS AND SETTINGS: Data were retrieved from the Premier Healthcare Database and comprised more than 15 million unique adult patient admissions from 937 hospitals. Patients were 18 years or older and admitted to a participating hospital between January 1, 2016, and December 31, 2019. METHODS: Given the absence of an IAD International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code, we categorized patients treated for IAD by selecting patients with a documented incontinence ICD-10-CM code and a documented charge for dermatology products used to treat IAD. The t test and χ2 tests determined whether incontinence and treatment for IAD were associated with outcomes. RESULTS: Incontinence prevalence was 1.5% for the entire sample; prevalence rate for IAD among incontinent patients was 0.7%. As compared to continent patients, incontinent patients had longer LOS (6.4 days versus 4.4 days), were 1.4 times more likely to be readmitted, 4.7 times more likely to have a sacral pressure injury upon admission pressure injury, 5.1 times more likely to have a sacral hospital-acquired pressure injury, and 5.8 times more likely to have a sacral pressure injury progress to a severe stage. As compared to incontinent patients without IAD treatment, those with IAD treatment had longer LOS (9.7 days versus 6.4 days), were 1.3 times more likely to be readmitted, and were 2.0 times more likely to have a sacral hospital-acquired pressure injury. Total index hospital costs were 1.2 times higher for incontinent patients and 1.3 times higher for patients with IAD treatment. CONCLUSIONS: Incontinence and IAD prevalence are substantially lower than past research due to underreporting of incontinence. The lack of an ICD-10-CM code for IAD further exacerbates the underreporting of IAD. Despite low prevalence numbers, our results show higher health care costs and worse outcomes for incontinent patients and patients with IAD treatment.


Assuntos
Dermatite , Incontinência Fecal , Lesão por Pressão , Atenção à Saúde , Dermatite/epidemiologia , Dermatite/etiologia , Incontinência Fecal/complicações , Incontinência Fecal/epidemiologia , Humanos , Lesão por Pressão/complicações , Lesão por Pressão/epidemiologia , Estudos Retrospectivos , Higiene da Pele
2.
Medicine (Baltimore) ; 100(42): e27155, 2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34678859

RESUMO

ABSTRACT: The focus of this prospective cohort study was to evaluate the risk factors of severe acute skin toxicity (grade ≥2) in 100 patients with breast cancer (BC) during radiotherapy (RT).The patients were evaluated weekly during RT and 3 months after treatment. The endpoint included the occurrence of skin toxicity grade ≥2, according to Radiation Therapy Oncology Group (RTOG). Survival analysis was conducted by univariate and multivariate Cox regression analysis.In the multivariate analysis, RT in the afternoon (0-3 pm) (hazard ratios [HR] = 1.566, P = .042) was significantly associated with the early occurrence of skin toxicity, indicating a potential effect of chronotherapy related to this adverse event. In the univariate and multivariate analysis, skin phototype moderate brown (HR = 1.586, P = .042; HR = 1.706, P = .022, respectively) and dark brown or black (HR = 4.517, P < .001; HR = 5.336, P < 0.001, respectively) was significantly associated with the skin toxicity. Tangential field separation >21 cm (HR = 2.550, P = .009, HR = 2.923, P = .003), in women that were submitted to conservative surgery indicates indirectly that large breast size was also significantly associated with skin toxicity.Women with large breasts and dark brown or black skin should be followed more carefully during RT, which should be undergone in the morning, especially when submitted to conventional RT techniques, common in developing countries.


Assuntos
Neoplasias da Mama/radioterapia , Dermatite/etiologia , Dermatite/prevenção & controle , Lesões por Radiação/prevenção & controle , Idoso , Índice de Massa Corporal , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Hospitais Universitários , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Doses de Radiação , Fatores de Risco , Pele/efeitos da radiação , Fatores Socioeconômicos
3.
Sci Rep ; 11(1): 17896, 2021 09 09.
Artigo em Inglês | MEDLINE | ID: mdl-34504268

RESUMO

This study assessed the clinical risk factors for periorbital dermatitis (PD) after using dorzolamide/timolol eye drops in a total of 1282 glaucoma patients. Both the PD(+) group and the PD(-) group were evaluated using clinical data such as age, sex, dosing duration, presence of benzalkonium chloride (BAK) in the formulation, ocular surgery history (e.g. cataract or glaucoma operations), height, weight, personal history of systemic hypertension, smoking, alcohol consumption, intraocular pressure, best-corrected visual acuity (BCVA), central corneal thickness, axial length, and visual field index (VFI). Univariate analyses showed that shorter dosing duration, higher rate of BAK-included cases, worse BCVA, worse VFI, more systemic hypertension history, and more ocular surgery history were more associated with the PD(+) group than the PD(-) group. The BAK(-) group showed a lower PD rate than the BAK-included group, which was supported by the Kaplan-Meier analysis (log-rank test, p = 0.0014). Multivariate analyses revealed that the probability of PD increased by 8 times if they had a history of ocular surgery and increased by 2.3% when the VFI decreased by 1% (Cox's hazard regression test, p < 0.001). Therefore, a preservative-free dorzolamide/timolol can benefit the subjects for those who had ocular surgery or who have worse VFI.


Assuntos
Dermatite/etiologia , Glaucoma/tratamento farmacológico , Soluções Oftálmicas/efeitos adversos , Conservantes Farmacêuticos/efeitos adversos , Sulfonamidas/efeitos adversos , Tiofenos/efeitos adversos , Timolol/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Criança , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
4.
Br J Nurs ; 30(15): S40-S46, 2021 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-34379461

RESUMO

Disruption to the integrity of the skin can reduce patient wellbeing and quality of life. A major cause of skin breakdown is prolonged exposure to moisture, but this is often overlooked. When skin is wet, it becomes more susceptible to damage from friction and shearing forces, and skin flora can penetrate the disrupted barrier, causing further irritation and inflammation. If untreated, moisture-associated skin damage (MASD) can rapidly lead to excoriation and skin breakdown. MASD includes incontinence-associated dermatitis (IAD), which is caused by prolonged skin exposure to urine and stool, particularly liquid stool. For patients at a high risk of developing IAD, preventive measures should be instituted as soon as possible. The main one is to prevent excessive contact of the skin with moisture. Optimal skin care should be provided to patients with any form of MASD. It should be based on a structured regimen and include the use of a gentle skin cleanser, a barrier product and moisturiser. Derma Protective Plus is a liquid barrier that gives long-lasting protection against chafing or ingress of urine and stool into the skin. This product is less greasy than others, and provides a barrier and a healing environment, with resistance to further maceration from IAD or persistent loose stools.


Assuntos
Dermatite , Dermatite/etiologia , Dermatite/prevenção & controle , Incontinência Fecal , Humanos , Qualidade de Vida , Higiene da Pele , Incontinência Urinária
6.
Pan Afr Med J ; 39: 73, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422196

RESUMO

Niacin or tryptophan deficiency causes pellagra. Isoniazid interferes with the absorption of niacin and individuals on Isoniazid (INH) are at risk of pellagra. Isoniazid preventive therapy (IPT) is the administration of isoniazid to immunosuppressed individuals to prevent active tuberculosis (TB). IPT, in sub-Saharan Africa, the region worst hit by HIV and with a high TB prevalence, is recommended. A 40-year-old, HIV+ Zambian woman on Antiretroviral therapy for five years and IPT for three months presented with a four-day history of constipation, generalised body weakness and irrelevant talk. She complained of a generalised rash, sloughing off, and darkening of the skin on the face, neck, forearms, and dorsum of both feet. A physical examination revealed features of pellagra, and rapid response to oral niacin reaffirmed the diagnosis of pellagra. Unlike typical cases of pellagra presenting with the classic 3 Ds of Diarrhoea, Dementia and Dermatitis, our patient presented with constipation instead of diarrhoea. A consideration of Pellagra in HIV+ patients on IPT whose diet is mostly maize-based will be beneficial, even if the classic 3 Ds of diarrhoea, dementia, and dermatitis are not wholly present. A timely diagnosis and prompt treatment of pellagra can be lifesaving.


Assuntos
Antituberculosos/efeitos adversos , Isoniazida/efeitos adversos , Pelagra/induzido quimicamente , Adulto , Fármacos Anti-HIV/administração & dosagem , Antituberculosos/administração & dosagem , Constipação Intestinal/etiologia , Demência/etiologia , Dermatite/etiologia , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Isoniazida/administração & dosagem , Niacina/administração & dosagem , Niacina/deficiência , Pelagra/diagnóstico , Tuberculose/prevenção & controle
7.
Eur J Med Res ; 26(1): 98, 2021 Aug 25.
Artigo em Inglês | MEDLINE | ID: mdl-34433495

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) is associated with a wide clinical spectrum of skin manifestations, including urticarial, vesicular, vasculitic and chilblain-like lesions. Recently, delayed skin reactions have been reported in 1% individuals following mRNA vaccination against SARS-CoV-2. The exact pathophysiology and the risk factors still remain unclear. PATIENTS AND METHODS: 6821 employees and patients were vaccinated at our institutions between February and June 2021. Every patient received two doses of the mRNA-1273 vaccine in our hospitals, and reported back in case of any side effects which were collected in our hospital managed database. RESULTS: Eleven of 6821 vaccinated patients (0.16%) developed delayed skin reactions after either the first or second dose of the mRNA-1273 vaccine against SARS-CoV-2. Eight of 11 patients (73%) developed a rash after the first dose, while in 3/11 (27%), the rash occurred after the second dose. More females (9/11) were affected. Four of 11 patients required antihistamines, with two needing additional topical steroids. All the cutaneous manifestations resolved within 14 days. None of the skin reactions after the first dose of the vaccine prevented the administration of the second dose. There were no long-term cutaneous sequelae in any of the affected individuals. CONCLUSION: Our data suggests that skin reactions after the use of mRNA-1273 vaccine against SARS-CoV-2 are possible, but rare. Further studies need to be done to understand the pathophysiology of these lesions.


Assuntos
Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Dermatite/etiologia , Eritema/etiologia , Adulto , Idoso , Dermatite/tratamento farmacológico , Dermatite/epidemiologia , Eritema/tratamento farmacológico , Eritema/epidemiologia , Feminino , Antagonistas dos Receptores Histamínicos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Esteroides/uso terapêutico , Vacinação/efeitos adversos
12.
J Wound Ostomy Continence Nurs ; 48(4): 285-291, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34186545

RESUMO

PURPOSE: The purpose of this quality improvement project was to use the best available evidence and expert opinion to develop and implement a simple inpatient nursing care guideline ("The Guideline") for patients with minor skin lesions, including candidiasis, skin tears, incontinence-associated dermatitis, and stage 1 and stage 2 pressure injuries that would not require a WOC nurse consultation. PARTICIPANTS AND SETTING: The Guideline was developed for nurses working on inpatient adult acute care units in a large community hospital in southwest Minnesota. APPROACH: The Guideline was validated for its clarity and appropriateness by internal and external hospital-based wound care nurses and implemented through in-person rounding on the nursing units and distribution of badge cards and required completing an online education module. Surveys and wound documentation audits were conducted to measure changes in knowledge and skin care pre- and postimplementation of The Guideline. OUTCOMES: We conducted wound documentation audits of approximately 491 records that assessed whether patients received appropriate treatment and found an improvement from 45% (104 of 231) to 80% (209 of 260). Nurses' self-rating of their knowledge about which dressings and topical treatment to use improved from 18% (16 of 89) agreement to 57% (55 of 96). Nurses' self-rating of their knowledge about when to change dressings and reapply topical treatments improved from 27% (24 of 89) agreement to 65% (62 of 96). IMPLICATIONS FOR PRACTICE: Although there is evidence for a variety of dressings or products to treat wounds, this quality improvement project demonstrated increased adherence with providing appropriate care when fewer treatment options were recommended to nursing staff through our structured guideline. The Guideline continues to be used at the project site and is now being implemented at affiliate hospitals.


Assuntos
Dermatite/etiologia , Dermatite/enfermagem , Incontinência Fecal/complicações , Incontinência Fecal/enfermagem , Guias de Prática Clínica como Assunto/normas , Melhoria de Qualidade , Higiene da Pele/enfermagem , Higiene da Pele/normas , Adulto , Hospitais , Humanos , Enfermeiras Clínicas , Sociedades de Enfermagem , Cicatrização
13.
Cutan Ocul Toxicol ; 40(2): 168-174, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34097555

RESUMO

BACKGROUND: Skin lesions are either caused by COVID-19 disease or they can be due to other driving forces related to the COVID-19 pandemic. AIM: Considering the fact that the reported data in different articles for the type and prevalence of skin manifestations related to the COVID-19 pandemic are inconsistent, we have described the mechanism and type of skin lesions related to the COVID-19 pandemic. METHODS: In this review article, we have searched the Medline database (PubMed) for the combination of the following key terms "Dermatological Manifestation", "cutaneous Manifestation", "Skin Manifestation", "COVID-19", "SARS-CoV-2". RESULTS: The prevalence of skin manifestations related to COVID-19 ranged from 0.2% to 20%. The majority of these skin lesions are maculopapular eruptions. The skin presentations related to the COVID-19 pandemic are described below. Traumatic skin conditions such as dermatitis in individuals, especially those with allergies, might initiate secondary to over-washing or rinsing with inappropriate detergents. Also, inappropriate use of personal protective equipment (mask-gloves-shield) can trigger skin lesions on the face and hands or aggravate the lesions of acne, seborrhoeic dermatitis, eczema, etc. Furthermore, cutaneous adverse drug reactions may occur during hospitalization or outpatient treatment of COVID-19 patients. Also, psychocutaneous disorders due to acute stress can trigger or deteriorate several skin manifestations. Moreover, COVID-19 prevalence and course may be changed in patients with autoimmune or chronic inflammatory underlying skin disorders such as psoriasis, lupus erythematosus, pemphigus, scleroderma who are on immunosuppressive or biological medications to control their disorders. CONCLUSION: Due to the various dimensions of skin organ involvement and the large population affected, long-term skin conditions following this pandemic can be a lot more problematic than it appears. Serious preventive measures and medical supports are necessary to avoid skin disorders from becoming permanent or even chronic.


Assuntos
COVID-19/patologia , Pele/patologia , COVID-19/complicações , COVID-19/prevenção & controle , Dermatite/etiologia , Desinfecção das Mãos , Humanos , Equipamento de Proteção Individual/efeitos adversos
14.
J Wound Ostomy Continence Nurs ; 48(3): 239-250, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33951713

RESUMO

Incontinence-associated dermatitis (IAD) has been studied over the last decades, but gaps in the knowledge related to its identification, etiological agents, and risk factors remain. We carried out a scoping review about IAD that included systematic reviews, experimental, and observational studies about IAD and its potential risk factors. We retrieved 24 articles that described 100 potential risk factors and which were synthesized by the authors and proposed to a panel of experts. Panelists used a structured process of consensus development to create a conceptual framework of factors associated with IAD. This framework proposes that liquid fecal material, when combined with exposure to urine and stool, and bacterial contaminated urine are etiological factors for development of IAD. The framework also proposes 2 pathophysiological mechanisms and 8 main risk factors for IAD development. The proposed model could improve the quality of care for patients with or at risk of IAD, assisting healthcare professionals to identify at-risk patients, diagnose the type of lesion, and establish adequate and effective prevention and treatment measures.


Assuntos
Formação de Conceito , Dermatite/etiologia , Incontinência Fecal , Incontinência Urinária , Consenso , Humanos , Fatores de Risco , Higiene da Pele
15.
Clin Dermatol ; 39(1): 23-32, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33972048

RESUMO

The first cases of coronavirus disease 2019 (COVID-19) in Iran were detected on February 19, 2020. Soon the entire country was hit with the virus. Although dermatologists were not immediately the frontline health care workers, all aspects of their practice were drastically affected. Adapting to this unprecedented crisis required urgent appropriate responses. With preventive measures and conserving health care resources being the most essential priorities, dermatologists, as an integral part of the health system, needed to adapt their practices according to the latest guidelines. The spectrum of the challenges encompassed education, teledermatology, lasers, and other dermatologic procedures, as well as management of patients who were immunosuppressed or developed drug reactions and, most importantly, the newly revealed cutaneous signs of COVID-19. These challenges have paved the way for new horizons in dermatology.


Assuntos
COVID-19/epidemiologia , COVID-19/prevenção & controle , Dermatologia/normas , Hospitais Universitários , Dermatopatias/etiologia , Dermatopatias/terapia , COVID-19/complicações , COVID-19/tratamento farmacológico , Técnicas Cosméticas , Dermatite/etiologia , Procedimentos Cirúrgicos Dermatológicos , Dermatologia/educação , Dermatologia/métodos , Dermoscopia , Erupção por Droga/etiologia , Dermatoses da Mão/etiologia , Desinfecção das Mãos , Humanos , Internato e Residência , Irã (Geográfico)/epidemiologia , Terapia a Laser , Equipamento de Proteção Individual/efeitos adversos , Fototerapia , Guias de Prática Clínica como Assunto , Prática Privada , SARS-CoV-2 , Dermatopatias/tratamento farmacológico , Telemedicina
16.
Int Wound J ; 18(6): 862-873, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33960676

RESUMO

Skin cleansers and protectants protect skin from incontinent matter to reduce the risk of incontinence-associated dermatitis (IAD), but their effectiveness treating established IAD in the tropics is unknown. We conducted an open-label cluster randomised trial to compare the effectiveness of a combined regimen of (1) specialised skin cleansers with disposable body wipes and (2) either an acrylic terpolymer (T1) or zinc oxide (T2) skin protectant against disposable body wipes and zinc oxide protectant (control) in promoting IAD healing and reducing the risk of deterioration. Eighty-four patients were recruited in a tertiary hospital in Singapore between April 2019 and January 2020 (T1: n = 23; T2: n = 37; Control: n = 24). Although not statistically significant, patients treated with T1 and T2 were 1.5 times as likely to experience IAD healing within seven days compared with the control (P = .66). Healing was more pronounced in participants with skin loss treated with T1 or T2. No treatment was superior in preventing IAD deterioration, the prevalence of which remained small (8%-14%). While skin cleaning and protectants reduced the overall risk of skin deterioration, the addition of skin cleansers enhanced IAD healing within a short period, an important consideration for future research examining IAD treatment in acute care.


Assuntos
Dermatite , Incontinência Fecal , Incontinência Urinária , Dermatite/tratamento farmacológico , Dermatite/etiologia , Dermatite/prevenção & controle , Emolientes , Humanos , Higiene da Pele , Incontinência Urinária/complicações , Incontinência Urinária/tratamento farmacológico
18.
J Wound Care ; 30(4): 261-267, 2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33856906

RESUMO

OBJECTIVE: Intensive care unit (ICU) patients possess multiple risk factors for developing loss of skin integrity, particularly incontinence-associated dermatitis (IAD). IAD is an inflammatory skin condition resulting from repeated and prolonged contact with urine, faeces or both. This study aimed to measure the incidence and clinical characteristics of adult ICU patients with IAD. METHOD: This was a prospective observational study conducted over three months in an adult ICU. Included patients were ≥18 years who experienced faecal incontinence during their intensive care admission. Patients were excluded if they had an ileostomy or colostomy, had IAD on admission, or were continent of urine and faeces. Skin inspections were performed every second day on all recruited patients by trained research nurses. Other data were collected from patient medical records. RESULTS: A total of 37 patients took part in the study. Incidence of IAD was 35.1%; 13 patients who had incontinence developed IAD. The mean time to onset of IAD was 3.69 days, median 3 days (SD: 1.8, range: 2-8 days). Of the 13 patients who developed IAD, 12 (92.3%) patients were initially assessed as having category 1 IAD and one (7.7%) patient was initially assessed with category 2 IAD. Of the patients with category 1 IAD, one patient (7.7%) progressed to category 2 IAD severity. CONCLUSION: A larger sample is recommended to fully explore ICU patient characteristics and IAD development. The incidence of IAD in ICU patients was high at 35%, indicating this condition requires due consideration in ICU patients.


Assuntos
Dermatite/etiologia , Incontinência Fecal/complicações , Higiene da Pele , Incontinência Urinária/complicações , Adulto , Dermatite/epidemiologia , Incontinência Fecal/epidemiologia , Humanos , Incidência , Unidades de Terapia Intensiva , Testes de Irritação da Pele , Incontinência Urinária/epidemiologia
19.
Int J Mol Sci ; 22(6)2021 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-33804685

RESUMO

The skin of an organism is affected by various environmental factors and fights against aging stress via mechanical and biochemical responses. Photoaging induced by ultraviolet B (UVB) irradiation is common and is the most vital factor in the senescence phenotype of skin, and so, suppression of UVB stress-induced damage is critical. To lessen the UVB-induced hyperimmune response and hyperpigmentation, we investigated the ameliorative effects of intense pulsed light (IPL) treatment on the photoaged phenotype of skin cells. Normal human epidermal keratinocytes and human epidermal melanocytes were exposed to 20 mJ/cm2 of UVB. After UVB irradiation, the cells were treated with green (525-530 nm) and yellow (585-592 nm) IPL at various time points prior to the harvest step. Subsequently, various signs of excessive immune response, including expression of proinflammatory and melanogenic genes and proteins, cellular oxidative stress level, and antioxidative enzyme activity, were examined. We found that IPL treatment reduced excessive cutaneous immune reactions by suppressing UVB-induced proinflammatory cytokine expression. IPL treatment prevented hyperpigmentation, and combined treatment with green and yellow IPL synergistically attenuated both processes. IPL treatment may exert protective effects against UVB injury in skin cells by attenuating inflammatory cytokine and melanogenic gene overexpression, possibly by reducing intracellular oxidative stress. IPL treatment also preserves antioxidative enzyme activity under UVB irradiation. This study suggests that IPL treatment is a useful strategy against photoaging, and provides evidence supporting clinical approaches with non-invasive light therapy.


Assuntos
Hipersensibilidade/etiologia , Hipersensibilidade/terapia , Terapia de Luz Pulsada Intensa , Transtornos da Pigmentação/etiologia , Transtornos da Pigmentação/terapia , Raios Ultravioleta/efeitos adversos , Antioxidantes/metabolismo , Biomarcadores , Células Cultivadas , Citocinas/metabolismo , Dermatite/etiologia , Dermatite/metabolismo , Dermatite/patologia , Humanos , Hipersensibilidade/patologia , Melaninas/biossíntese , Estresse Oxidativo/efeitos da radiação , Fototerapia , Pigmentação/efeitos da radiação , Transtornos da Pigmentação/metabolismo , Transtornos da Pigmentação/patologia , Espécies Reativas de Oxigênio/metabolismo , Pele/metabolismo , Pele/patologia , Pele/efeitos da radiação , Envelhecimento da Pele/efeitos da radiação
20.
J Wound Care ; 30(Sup4): S24-S27, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33856927

RESUMO

OBJECTIVE: The primary goals of managing incontinence-associated dermatitis (IAD) are to control the incontinence and to stop the progress of dermatitis. This study evaluated the effectiveness of using a combination of topical antibiotic and topical antifungal medication to manage IAD. METHOD: Patients with grade 2 IAD treated with a combination of topical antibiotic Biomycin (CBC Biotechnological and Pharmaceutical, Taiwan) and antifungal clotrimazole (Sinphar Group, Taiwan) between January 2017 and January 2019 were included in this retrospective study. Data collected included patients' age, sex, diagnosis, body mass index, comorbidities and surface area involved. Patients were reviewed fortnightly until the wounds had healed, the patient was discharged or had died. RESULTS: A total of 76 patients were included. There were 39 men and 37 women with a mean age of 74 years. In 58 (76%) patients, the surface area involved was >50cm2, in 13 (17%) patients the involved area was 20-50cm2 and in five (7%) patients the area involved was <20cm2. The mean number of days treated was 10.3 (range: 1-53). A total of 46 (61%) patients showed total healing of their IAD, 17 (22%) patients showed improvement of >50% of the involved area, seven (9%) patients showed improvement of 0-50%, five (7%) patients showed no improvement and one (1%) patient showed an increase in the area involved. CONCLUSION: This combination of treatment was effective in the management of IAD. It was cheap, easy to apply, easy to remove and easily accessible. It could be used efficiently by the hospital staff and the patient's family.


Assuntos
Antifúngicos/uso terapêutico , Dermatite/tratamento farmacológico , Incontinência Fecal/complicações , Idoso , Antibacterianos/uso terapêutico , Antifúngicos/administração & dosagem , Dermatite/etiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos , Higiene da Pele
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