Adult Incontinence and its Influence on Pressure Sores

Incontinence can be defined as the uncontrolled elimination of urine or fecal material from the body. When controlled this material is either deposited away or washed away from the body to maintain a hygienic environment. When uncontrolled the waste can collect on the skin and cause various factors which contribute to skin breakdown and ultimately pressure sores.

Incontinence can carry contaminants to the skin surface. Although normal urine is sterile and bacteriostatic, urinary incontinence which is from an individual with a urinary tract infection will carry the organism the individual is infected with. Fecal incontinence will always carry E Coli bacteria and may carry other organisms present in the individual’s bowel.

Urine when held against the skin increases the likelihood of maceration of the tissue and will not promote good skin health. Increased moisture prevents the proper maintenance of the moistness of the tissues and the evaporation of the moisture promotes the over drying of the skin area and will increase cracking and peeling. This effectively eliminates the skins natural barrier to infection. It also increases the opportunity for sheering.

Proper skin maintenance depends on a clean, dry, moisture and humidity controlled area. The use of products which have a wicking effect to the moisture, minimizing the area moistened by the incontinence is essential. Products which can be sanitized for long term use is important in promoting skin health by reducing contaminants. Increased local skin temperatures which arise from the bundling of cloth towards the individual’s skin also are significant to promoting skin breakdown and should be discouraged.

When a good washable incontinence product is used, the insidious effects of incontinence can be minimized. Combining incontinence control with the use of a positioning system designed to promote air flow and also be sanitized easily, humidity and contaminants can be controlled. Temperature regulation also becomes easier when the entire bed surface is not saturated in the event that the individual is incontinent.
It is therefore important to choose a good technically correct source of incontinence supply when shopping for the bed bound or debilitated individual. Incontinence pants and incontinence diapers are not the only way to control adult incontinence and even urinary stress incontinence. A good adult incontinence product is measured by its wicking ability; its ability to be sanitized and its ease of use.

References: Clinical Practice Guidelines #15; “Treatment of Pressure Ulcers,” U.S. Department of Health and Human Service, Agency for Health Care Policy and Research,
December, 94, “Pressure Sore Prevention and Treatment Following Spinal Cord Injury”: A Clinical Practice Guideline for Health-Care Professionals; Consortium for Spinal Cord Medicine, August, 2000