不同的皮膚照護方案對成人失禁性皮膚炎之改善成效：系統性文獻回顧

The Performance of Different Skin Care Protocols for Incontinence-Associated Dermatitis in Adult: A Systematic Review of the Literature

林筱青(Hsiao-Ching Lin) ； 許晉豪(Chin-Hao Hsu) ； 張簡志炫(Chih-Hsuan Chang-Chien) ； 楊正三(Sam Yang)

《南臺灣醫學雜誌》 12卷2期 (2016/12) Pp. 103-114

https://doi.org/10.6726/MJST.201612_12(2).0007

摘要

失禁排泄物會浸潤肛門、會陰皮膚導致對失禁性皮膚炎(Incontinence-associated dermatitis, IAD) ，即使臨床照護者已經勤於清潔與更換尿布，亦會因缺乏皮膚清潔及防護品的知識，照護方式不一致而無法有效改善臨床症狀。為探討不同的皮膚照護方案對IAD之改善成效，以系統性文獻回顧的方式，查閱1987年1 月至2016年5月的文獻， 依關鍵字檢索，選取符合篩選標準及排除重複出現文獻，最後納入12篇隨機臨床試驗文獻。這些證據支持良好的皮膚清潔、隔離防護、尿布選擇及護理頻率，能改善IAD， 並可供臨床照顧者參考， 以提升照護品質。

關鍵字

成人 ； 失禁性皮膚炎 ； 皮膚照顧方案

並列摘要

Patients with fecal and urinary incontinence are frequently afflicted by incontinence associated dermatitis (IAD), which is manifested by redness, with or without erosion of dermis and a macerated appearance of anus or perineum skin. Even if the care is provided by health care professionals, IAD could still occur. Reasons of non-healing IAD could attribute to inconsistency of skincare protocols, insufficient knowledge about skincare products and skincare cleaning practice. These could lead to problems of inferior care quality and harm the trust between caregiver and family. The purpose of this paper is to evaluate and compare the effects between the different skin care protocols for IAD. Randomized clinical trials involving subjects with IAD care improvement were searched from January 1987 to May 2016 database and 12 articles were selected based on the searching criteria. Satisfactory evidences of how to improve IAD were identified after analysis of these 12 articles, including protocols of good skin cleansing, skin barrier, proper choices of diapers, and frequency of nursing care. This paper provides a guideline for proper IAD management and raises awareness of early intervention of IAD among clinical caregivers.

並列關鍵字

incontinence-associated dermatitis ； adult ； skin care