Recomendações baseadas em evidências para prevenção e tratamento de dermatite associada à incontinência

Abstract

The incontinence associated dermatitis (DAI) describes a clinical manifestation of skin lesions associated with humidity, common in patients with incontinence. The objective is to establish evidence-based recommendations for the prevention and treatment of DAI. The methodology was based on Evidence-Based Practice and Integrative Review. The gathering took place in December 2012 in MEDLINE, CINAHL, Cochrane Library, SCIELO IBECS, BEDNF, LILACS through descriptors Irritant Dermatitis, Contact Dermatitis, Diaper Rash, Urinary Incontinence, Fecal Incontinence, Fecal Incontinence. 58 articles were identified and selected two that met the inclusion criteria. Both studies were conducted by sample nurse specialists and published English, both in the Journal of Wound, Ostomy, and Continence Nursing, in 2007 and 2011. Both were controlled clinical trials, with and without randomization, whose sample was 141 and 981 elderly patients who underwent a care regimen DAI. Established 12 recommendations, four on prevention (level III), two on treatment (level II) and six general recommendations on prevention and treatment (level II). Care to prevention involves cleaning and skin protection; treatment advocates use of the device (diaper) and product application in the injured area. General guidelines recommend development of a protocol, staff training, patient assessment incontinent, minimizing contact with irritants and how to sanitize the skin. The main recommendations were: use system for preventing DAI which includes pH balanced cleansing, skin hydration and moisture barrier, use some substances that combine zinc oxide and dimethicone with petrolatum. We conclude that the prevalence of DAI is lower when using a well-defined system of care, as well as its development and its severity may also decrease.