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The influence of incontinence pads moisture at the loaded skin interface

The influence of incontinence pads moisture at the loaded skin interface
The influence of incontinence pads moisture at the loaded skin interface
Aim: prolonged mechanical loading on soft tissues adjacent to bony prominences can lead to pressure ulcers. The presence of moisture at the skin interface will lower the tolerance to load. Absorbent pads manage moisture in individuals with incontinence, although their role in maintaining skin health is unknown. The present study investigated the effects of moist incontinence pads on skin physiology after periods of mechanical loading.

Material and methods: twelve healthy participants were recruited to evaluate a single incontinence pad design under three moisture conditions: 0% (dry), 50% and 100% fluid capacity. For each pad condition, pressure (9 kPa) or pressure in combination with shear (3 N) was applied to the sacrum, followed by a period of off-loading. Measures included trans-epidermal water loss (TEWL) and inflammatory biomarkers sampled at the skin interface.

Results: results revealed no change in TEWL in the loaded dry pad condition. By contrast, when the pads contained moisture, significant increases in TEWL were observed. These increases were reversed during off-loading. Inflammatory biomarkers, specifically IL-1α/total protein ratio, were up-regulated during dry pad loading, which recovered during off-loading. Loaded moist pads caused a significant increase in biomarkers, which remained elevated throughout the test period.

Conclusion: the study revealed a marked compromise to stratum corneum integrity when the skin was exposed to moist incontinence pads in combination with mechanical loads. These physiological changes were largely reversed during off-loading. Incontinence pads provided some protection in the dry state, although more research is required to determine optimal clinical guidance for their use.
0965-206X
Bostan, Luciana
9b269056-e210-4ab7-815a-f373528dcd66
Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
Abbas, Shabira
05715685-ebaf-410f-a2bc-04953c472226
Bader, Daniel
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf
Bostan, Luciana
9b269056-e210-4ab7-815a-f373528dcd66
Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
Abbas, Shabira
05715685-ebaf-410f-a2bc-04953c472226
Bader, Daniel
9884d4f6-2607-4d48-bf0c-62bdcc0d1dbf

Bostan, Luciana, Worsley, Peter, Abbas, Shabira and Bader, Daniel (2019) The influence of incontinence pads moisture at the loaded skin interface. Journal of Tissue Viability. (doi:10.1016/j.jtv.2019.05.002).

Record type: Article

Abstract

Aim: prolonged mechanical loading on soft tissues adjacent to bony prominences can lead to pressure ulcers. The presence of moisture at the skin interface will lower the tolerance to load. Absorbent pads manage moisture in individuals with incontinence, although their role in maintaining skin health is unknown. The present study investigated the effects of moist incontinence pads on skin physiology after periods of mechanical loading.

Material and methods: twelve healthy participants were recruited to evaluate a single incontinence pad design under three moisture conditions: 0% (dry), 50% and 100% fluid capacity. For each pad condition, pressure (9 kPa) or pressure in combination with shear (3 N) was applied to the sacrum, followed by a period of off-loading. Measures included trans-epidermal water loss (TEWL) and inflammatory biomarkers sampled at the skin interface.

Results: results revealed no change in TEWL in the loaded dry pad condition. By contrast, when the pads contained moisture, significant increases in TEWL were observed. These increases were reversed during off-loading. Inflammatory biomarkers, specifically IL-1α/total protein ratio, were up-regulated during dry pad loading, which recovered during off-loading. Loaded moist pads caused a significant increase in biomarkers, which remained elevated throughout the test period.

Conclusion: the study revealed a marked compromise to stratum corneum integrity when the skin was exposed to moist incontinence pads in combination with mechanical loads. These physiological changes were largely reversed during off-loading. Incontinence pads provided some protection in the dry state, although more research is required to determine optimal clinical guidance for their use.

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The influence of incontinence pads moisture at the loaded skin interface - Accepted Manuscript
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More information

Accepted/In Press date: 24 May 2019
e-pub ahead of print date: 29 May 2019

Identifiers

Local EPrints ID: 431511
URI: http://eprints.soton.ac.uk/id/eprint/431511
ISSN: 0965-206X
PURE UUID: b090eba2-aca4-43e4-8975-4919bc32caad
ORCID for Luciana Bostan: ORCID iD orcid.org/0000-0003-3882-2619
ORCID for Peter Worsley: ORCID iD orcid.org/0000-0003-0145-5042
ORCID for Daniel Bader: ORCID iD orcid.org/0000-0002-1208-3507

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Date deposited: 06 Jun 2019 16:30
Last modified: 22 Nov 2021 07:25

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Contributors

Author: Luciana Bostan ORCID iD
Author: Peter Worsley ORCID iD
Author: Shabira Abbas
Author: Daniel Bader ORCID iD

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