A multiple patient evaluation of a Flamigel® for the clinical management and treatment of patients with Incontinence Associated Dermatitis in elderly care settings
Incontinence Associated Dermatitis (IAD) is caused by the inflammation and or erosion of the skin associated with exposure to urine or stool. Urine predispose exposed skin to over hydration, increased pH, and enhance the level of friction when moist skin moves across clothing while faecal incontinence break down proteins and fats which are critical components of the natural skin moisture barrier( Gray, 2012)
In Cyprus, as in many other countries the exact number of patients affected with IAD is not know due to the difficulties of recognising and distinguishing the condition from pressure ulcers and the lack of criteria in doing so.
It has been reported that the prevalence rate of IAD is between 5.6%-50% (Bliss et al, (2006) Beckmann et al (2014) while the incidence rate lies among 3, 4%-25% (Long M et al 2012).
The purpose of our study was to
a) treat IAD in elderly patients and alleviate their experience of discomfort, pain, itching, or tingling in the affected areas by using Flamigel®, (Hydroactive Colloid Gel®, Flen Health) which has both anti-inflammatory and antibacterial properties and can prevent secondary skin infections.
b) Prevent the recurrence of IAD and its secondary complications by using the Flamigel® as part of a structured skin regimen after each episode of incontinence.
30 patients were assessed by us and diagnosed with IAD. 12 of them had IAD buttocks and thighs, 8 had IAD on genitalia, left and right groin, lower abdomen, and left and right inner thigh and 10 patients had IAD on buttocks only. Twenty of them were residents of various nursing homes and ten of them were looked after in the community. All of them were treated with the Flamigel®, although six patients looked after by home carers in the community did not agree to follow a structured skin regimen after successful treatment. All patients were followed for a period of three months in order to identify a recurrence pattern.
All patients reported a cooling effect after the first application of the Flamigel®, reduction in pain levels from 9 to 4, and alleviation of the itching they were experiencing. IAD was treated effectively with the use of Flamigel®. 24 patients who had continued to use the Flamigel® as part of their structured skin regimen reported no incidence of recurrence of IAD. However, the six patients who did not use the Flamigel® as part of their skin regimen after healing reported recurrence within a period of 10 days after complete healing.
Although this is very small case studies, it suggests that the Flamigel® is effective in treating IAD and reducing pain and discomfort as well as preventing recurrence of IAD. Even more, the patients’ quality of life was significantly improved.