İnkontinansa Bağlı Dermatit: Değerlendirme, Önleme ve Tedavi
Üriner ve fekal inkontinas, hastanın fiziksel, sosyal, psikolojik olarak yaşantısını etkileyen
ve ekonomik yük getiren önemli bir sağlık sorunudur. İnkontinansın yol açtığı en yaygın
deri sorunu inkontinansa bağlı dermatittir. Hemşirelik bakımı ile yakından ilişkili olan
inkontinansa bağlı dermatit; deride idrar ve/veya dışkı temasına bağlı olarak gelişen perineal
tahriştir. İnkontinans alakalı dermatit, bireyin sağlığını ve yaşam kalitesini etkilemenin yanı
sıra para, zaman ve iş gücü kayıplarına yol açar. Sınırlı sayıdaki çalışmada inkontinansa bağlı
dermatit prevalansı %5.6’dan %50’ye kadar değişen aralıkta verilmiştir. İnkontinansı yönetmek
ve yapılandırılmış bir deri bakımı uygulamak, inkontinansa bağlı dermatitin önlenmesinde
ve tedavisinde anahtar girişimlerdir. Bu makalede inkontinansa bağlı dermatitin önlenmesi
ve tedavisi güncel kanıtlar doğrultusunda ele alınmıştır.
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- 1. Gray M, Bliss DZ, Ermer SJ, Kennedy E, Karen L, Palmer MH. Incontinence associated dermatitis: a
consensus. Journal of Wound, Ostomy, and Continence Nursing 2007; 34(1):45-54.
- 2. Proceedings of the Global İBD Expert Panel. İnkontinansa bağlı Dermatit: Önlemeyi Geliştirme.
Wounds International 2015. URL: http://www.woundsinternational.com. 23 Eylül 2016.
- 3. Bale S, Tebble N, Jones V, Price P. The benefits of implementing a new skin care protocol in nursing
homes. J Tissue Viabil 2004;14(2):44-50.
- 4. Filiz TM, Uludag C, Cinar N, Gorpelioglu S, Topsever P. Risk factors for urinary incontinence in Turkish
women. A cross-sectional study. Saudi Med J 2006;27(11):1688-1692.
- 5. Tozun M, Ayrancı U, Unsal A. Prevelance of urinary incontinence among women and its impact on
quality of life in a semirural area of western Turkey. Gynecol Obstet Invest 2009;67(4):241-249.
- 6. Denat D, Khorshid L. Fekal inkontinansin bakimi ve bakimda kullanilan ürünler. Atatürk Üniversitesi
Hemşirelik Yüksekokulu Dergisi 2009;12(2 ):94-103.
- 7. Junkin J, Selekof JL. Beyond “diaper rash”: Incontinence-associated dermatitis: Does it have you seeing
RED? Nursing 2008;38(11):56-67.
- 8. Bliss DZ, Savik K, Thorson MAL, Ehman S, Lebak K, Beilman G. (2011). Incontinence-associated
dermatitis in critically ill adults: time to development, severity, and risk factors. Journal Wound Ostomy
Continence Nursing 2011;38(4):1-13.
- 9. Gray M, Beeckman D, Bliss DZ, Donna Z, Fader M, Logan S, et al. Incontinence-associated dermatitis: A
comprehensive review and update. Journal Wound Ostomy Continence Nursing 2012;39(1):61-74.
- 10. Copson D. Management of tissue excoriation in older patients with urinary or faecal incontinence.
Nursing Standard 2006;21(7):57-62.
- 11. Corcoran E, Woodward S. Incontinence-associated dermatitis in the elderl:treatment options. British
Journal of Nursing 2013; 22(8):450-457.
- 12. Bliss DZ, Savik K, Harms S, Fan Q, Wyman JF. Prevalence and correlates of perineal dermatitis in
nursing. Nursing Research 2006;55:243-251.
- 13. Ehman S, Thorson M, Lebak K, Bliss DZ, Savik K, Thorson MAL. Development of perineal dermatitis in
critically ill adults with fecal incontinence. American Journal of Critical Care 2006;15:333-339.
- 14. Junkin J, Selekof JL. Prevalence of incontinence and associated skin injury in the acute care inpatient.
Journal of Wound Ostomy Continence Nursing, 2007;34:260-269.
- 15. Bliss DZ, Zehrer C, Savik K, Smith G, Hedblom E. An economic evaluation of four skin damage
prevention regimens in nursing home residents with incontinence: economics of skin damage
prevention. Journal Wound Ostomy Continence Nursing 2007;34:143-152.
- 16. Arnold-Long.Incontinence-Associated Dermatitis (IAD) in a Long Term Acute care (LTAc) Facility:
Findings from a 12 Week Prospective Study. [Abstract] 2011. WOcN National conference, New Orleans LA.
- 17. Denat Y, Khorshid L. The effect of 2 different care products on incontinence-associated dermatitis in
patients with fecal incontinence. Journal of Ostomy Continence Nursing. 2011;38(2):171-176.
- 18. Avşar P, Karadağ A. Doku Toleransını Artırmaya Yönelik Hemşirelik Girişimlerinin Doku
Bütünlüğünün Sürdürülmesine Etkisi ve Maliyet Etkinlik Analizi. Yayınlanmamış Doktora Tezi. 2016.
Gazi Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
- 19. Junkin J, Moore-Lisi L, Selekof JL. What we don’t know can hurt us. Pilot prevalence survey of
incontinence and related perineal skin injury in acute care. [Abstract] 2005. WOcN National conference,
Las Vegas NV, June 2005.
- 20. Zehrer C L, Newman DK, Grove GL, Lutz JB. Assessment of diaper- clogging potential of petrolatum
moisture barriers. Ostomy Wound Manage 2005;51:54-58.
- 21. Frantz RA, Xakellis GC, Harvey PC, Lewis AR. Implementing an incontinence management protocol
in long-term care. Clinical outcomes and costs. Journal of Gerontological Nursing 2003;29(8):46-53.
- 22. Black JM, Gray M, Bliss DZ, Evans KL, Logan S, Baharestani MM, et al. (2011). MASD Part 2:
Incontinence-associated dermatitis and intertriginous dermatitis. Journal Wound Ostomy Continence
Nursing 2011;38(4):359-70.
- 23. Langemo D, Hanson D, Hunter S, Thompson P, Oh IE. Incontinence and incontinence associated
dermatitis. Advanced Skin Wound Care 2011;24(3):126-140.
- 24. Shiu SR, Hsu MY, Chang SC, Hui CC, Hsiao HH. Prevalence and predicting factors of incontinenceassociated
dermatitis among intensive care patients. Journal of Nursing Healthcare Research
2013;9(3):210-218.
- 25. Beeckman D, Schoonhoven L, Verhaeghe S, Heyneman A, Defloor T. Prevention and treatment of
incontinence-associated dermatitis: literatüre review. Journal of Advance Nursing 2009; 65(6):1141–1154.
- 26. Brown SD, Sears M. Perineal dermatitis: a conceptual framework. Journal of Ostomy Wound
Management 1993; 39(7):20-25.
- 27. Borchert K, Bliss DZ, Savik K. The Incontinence- Associated Dermatitis and its severity instrument.
Journal of Wound, Ostomy and Continence Nursing 2010;37(5):527–535.
- 28. Morris L. Flexi-Seal® faecal management system for preventing and managing moisture lesions. Wounds
United Kingdom 2011;7(2):88-93.
- 29. Nix DH. Factors to consider when selecting skin cleansing products. Journal Wound Ostomy Continence
Nursing 2000;27(5):260-268.
- 30. Moncrieff G, Cork M, Lawton S, Kokiet S, Daly C, Clark C. Use of emollients in dry-skin conditions:consensus
statement. Journal of Clinical & Experimental Dermatology Research 2013;38:231-38