Absorbent products and their impact on skin health.

Effective treatment and/or management of incontinence is essential because incontinence can affect a nursing home resident's physical and emotional health in a variety of ways. Residents with incontinence often have other risk factors associated with the condition. One of these, unfortunately, is the increased danger of pressure-sore development as a result of reduced mobility and skin wetness.

Pressure sores can be a significant health problem for elderly residents. Statistics show that a typical pressure sore takes weeks to heal and can cost as much as $30,000 for hospital treatment. For the elderly, these sores can open the door to life-threatening infections.

Clearly, it is more efficient to avoid pressure sores than it is to treat them. To minimize the incidence of pressure sores, especially in treating men and women with incontinence, it is important to limit or reduce moisture contact with the skin by keeping residents as active as possible and by providing proper incontinence management. Caregivers should also:

* monitor skin conditions closely;

* reposition immobile residents frequently;

* lift residents to avoid skin friction;

* use protective padding for body pressure points;

* provide thorough perineal care;

* keep skin clean and dry; and

* encourage proper nutrition.

Effective absorbent products, used in conjunction with the above care procedures, can help alleviate the problems associated with pressure sores.

The U.S. Department of Health and Human Services (HHS), in a publication titled Pressure Ulcers in Adults: Prediction and Prevention, says, "Minimize skin exposure to moisture due to incontinence, perspiration or wound drainage to help prevent skin damage...Underpads or briefs can be used that are made of materials that absorb moisture and present a quick-drying surface to the skin."

RECOMMENDING INCONTINENCE-CARE PRODUCTS

Because moisture control is so critical in preventing and treating pressure sores, it is important to use the most effective incontinence products available.

A statistical analysis of federal government data shows that nursing homes that used Attends incontinence care products as part of their overall program of incontinence care reported a significantly lower incidence of pressure sores.

Procter & Gamble, maker of Attends incontinence care products (briefs, pads, undergarments and washcloths), conducted the analysis, using data from 1990-91 Health Care Financing Administration (HCFA) nursing home licensure surveys of 15,895 nursing homes. HCFA is a division of HHS.

The analysis indicated that pressure-sore incidence was greatest at facilities where cloth incontinence products were used. Nursing homes that used disposable products (all brands then available) reported a 16% lower incidence of pressure sores than those using cloth products. Facilities using Attends reported the lowest incidence of pressure sores, 24% fewer than those using cloth.

While Attends products alone do not prevent the occurrence of pressure sores, they do effectively limit moisture (urine) contact with the skin, thus minimizing a key contribution to pressure-sore development. Using such products can be an important part of developing an effective discharge plan for residents with incontinence.

Colleen Nakamura, RN, CFNP, is Manager of Professional Education, Procter & Gamble Attends.