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      Efectividad de películas de barrera no irritantes y pomada con óxido de zinc: revisión exploratoria Translated title: Effectiveness of non-irritant barrier films and zinc oxide ointment: a scoping review

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          Abstract

          RESUMEN Objetivos: Valorar la efectividad de las películas de barrera no irritante (PBNI) y la pomada de óxido de zinc (ZnO) en la prevención y tratamiento de lesiones asociadas a la incontinencia (DAI). Metodología: Revisión exploratoria en las principales bases de datos bibliográficas (PubMed, CINAHL, LILACS, CUIDEN y Embase). Estudios de investigación acerca de las PBNI y las pomadas de ZnO desde 2010 hasta febrero de 2021, sin límite de idiomas. Criterios de inclusión: revisiones sistemáticas, artículos originales de cualquier tipo y tesis doctorales que relacionen la crema de ZnO o la PBNI con la prevención o tratamiento de la incontinencia urinaria o mixta, así como estudios que evalúen su rentabilidad o efectos secundarios. Resultados: Se han analizado 12 estudios: 5 ensayos clínicos aleatorios, 6 revisiones sistemáticas y 1 estudio descriptivo. No se ha hallado superioridad de eficacia de la PBNI frente a la pomada de ZnO, aunque aún se precisan más estudios para un posicionamiento, sí parece que la evidencia hasta el momento respalda una superior rentabilidad de la PBNI por coste por proceso. Conclusiones: Se precisaría de una herramienta estandarizada y validada de evaluación de la piel de la DAI. Se requieren más ensayos clínicos con un tamaño muestral más grande para poder comparar los diferentes productos y presentaciones con un diseño adecuado para poder realizar un metaanálisis después, y objetivos de estudio tanto de prevención como de tratamiento.

          Translated abstract

          ABSTRACT Objectives: To assess the primary and secondary studies generated from 2010 to the present on the effectiveness of non-irritant barrier films (NIBF) and zinc oxide ointment (ZnO) in the prevention and treatment of incontinence-associated injuries (IAD). Methods: Scoping review in the main bibliographic databases (PubMed, CINAHL, LILACS, CUIDEN and Embase). Research studies on LIPNPs and ZnO ointments from 2010 to February 2021, with no language limit. Inclusion criteria: systematic reviews, original articles of any type and doctoral theses linking ZnO cream or PBNI to the prevention or treatment of urinary or mixed incontinence, as well as studies evaluating their cost-effectiveness or side effects. Results: Twelve studies were analyzed: 5 randomized clinical trials, 6 systematic reviews and 1 descriptive study. No superiority of efficacy of PBNI over ZnO ointment was found, more studies are still needed for a position but it does appear that the evidence so far supports a superior cost-effectiveness of PBNI on a cost per process basis. Conclusions: A standardized and validated IAP skin assessment tool would be required. More clinical trials with a larger sample size are needed to compare the different products and presentations with an adequate design to be able to perform a meta-analysis afterwards, and study objectives for both prevention and treatment.

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          Most cited references48

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          A decade of research on Incontinence-Associated Dermatitis (IAD): Evidence, knowledge gaps and next steps

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            Incontinence-Associated Dermatitis: Pathogenesis, Contributing Factors, Prevention and Management Options.

            Incontinence-associated dermatitis (IAD) is a common type of irritant contact dermatitis, seen in patients with urinary or faecal incontinence. Mechanical factors such as traumata and friction may aggravate the lesions. The fragile skin in elderly patients is more prone to developing IAD. The clinical picture of IAD consists of persistent redness on the one hand and skin loss on the other. Both categories may be associated with clinical signs of major colonisation or infection. It is important to distinguish IAD from pressure ulcers and other dermatoses in the genital region. Due to the lack of well-established clinical trials, recommendations about prevention and treatment are based on expert opinion and best practice. Gentle cleansing, use of hydrating topical agents and application of barrier products are the main elements in the prevention and treatment of IAD. It is important to translate these recommendations and general guidelines into ready-to-use protocols that can be implemented for each specific clinical manifestation of IAD.
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              Optimal management of incontinence-associated dermatitis in the elderly.

              Mikel Gray (2010)
              Incontinence-associated dermatitis (IAD), sometimes referred to as perineal dermatitis, is an inflammation of the skin associated with exposure to urine or stool. Elderly adults, and especially those in long-term care facilities, are at risk for urinary or fecal incontinence and IAD. Traditionally, IAD has received little attention as a distinct disorder, and it is sometimes confused with stage I or II pressure ulcers. However, a modest but growing body of research is beginning to provide insights into the epidemiology, etiology, and pathophysiology of IAD. In addition, recent changes in reimbursement policies from the US Center for Medicare and Medicaid Services regarding pressure ulcer prevention has focused attention on the differential diagnosis of IAD versus pressure ulcer, and its influence on pressure ulcer risk. Color, location, depth, and the presence or absence of necrotic tissue are visual indicators used to differentiate IAD from pressure-related skin damage. Prevention is based on avoiding or minimizing exposure to stool or urine combined with a structured skin-care program based on principles of gentle cleansing, moisturization, preferably with an emollient, and application of a skin protectant. Treatment of IAD focuses on three main goals: (i) removal of irritants from the affected skin; (ii) eradication of cutaneous infections such as candidiasis; and (iii) containment or diversion of incontinent urine or stool.
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                Author and article information

                Journal
                geroko
                Gerokomos
                Gerokomos
                Sociedad Española de Enfermería Geriátrica y Gerontológica (Barcelona, Barcelona, Spain )
                1134-928X
                2022
                : 33
                : 1
                : 45-52
                Affiliations
                [1] Santander Cantabria orgnameUniversidad de Cantabria orgdiv1Máster Universitario en Gestión Integral e Investigación de las Heridas Crónicas Spain
                Article
                S1134-928X2022000100011 S1134-928X(22)03300100011
                fedc1a53-623e-4f94-b757-aa37a9cb0042

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 02 November 2021
                : 16 December 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 51, Pages: 8
                Product

                SciELO Spain

                Categories
                Helcos

                zinc oxide cream,moisture damage,incontinence-associated dermatitis,urinary incontinence,revisión exploratoria,mixed incontinence,scoping review,Película de barrera,crema de óxido de zinc,lesión por humedad,dermatitis asociada a la incontinencia,incontinencia urinaria,incontinencia mixta,Barrier film

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