{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T15:02:46Z","timestamp":1786460566034,"version":"build-2736575974"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,5]]},"abstract":"EXECUTIVE SUMMARY<\/jats:title>\n \n Background<\/jats:title>\n Incontinence-associated dermatitis (IAD) is inflammation of the skin resulting from repeated contact with urine and\/or feces. It causes pain, redness, swelling and excoriation, and may lead to complications such as fungal skin infections and pressure injuries. It is important to prevent and treat IAD to avoid complications and improve patient outcomes. A number of products are available for protecting skin, but evidence on their effectiveness is limited.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n The current review aimed to establish the effectiveness of topical skin products in reducing the occurrence and\/or severity of IAD.<\/jats:p>\n <\/jats:sec>\n \n Inclusion criteria Types of participants<\/jats:title>\n Adult patients over the age of 18 years with incontinence and\/or diarrhea.<\/jats:p>\n <\/jats:sec>\n \n Types of intervention<\/jats:title>\n Topical skin products as individual interventions or part of a skin care regimen.<\/jats:p>\n <\/jats:sec>\n \n Types of studies<\/jats:title>\n Both published and unpublished study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental, before and after, prospective and retrospective cohort, case-control, analytical cross-sectional, descriptive study designs including case series, individual case reports and descriptive cross-sectional studies across all care settings for inclusion.<\/jats:p>\n <\/jats:sec>\n \n Outcomes<\/jats:title>\n The primary outcome of interest was the absence or non-development, reduction or resolution, new development or increase in the occurrence of IAD or the increase in severity of IAD. The secondary outcome was any adverse effect caused by the skin care products used.<\/jats:p>\n <\/jats:sec>\n \n Search strategy<\/jats:title>\n A three-step search strategy to find both published and unpublished papers was utilized in this review. Studies were limited to those published in English from 1980 to 2016.<\/jats:p>\n <\/jats:sec>\n \n Methodological quality<\/jats:title>\n Papers selected were assessed by two independent reviewers using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI).<\/jats:p>\n <\/jats:sec>\n \n Data extraction<\/jats:title>\n Data were extracted using the standardized data extraction tool in JBI-MAStARI. The data extracted included specific details about the interventions, populations, study methods and outcomes.<\/jats:p>\n <\/jats:sec>\n \n Data synthesis<\/jats:title>\n Studies were assessed for methodological quality and statistical significance to determine validity and generalizability of study results. It was not possible to pool studies to conduct meta-analysis or test for heterogeneity.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n There were a limited number of clinical trials that compared products for efficacy in preventing and treating IAD. Assessment tools and severity scores used to measure skin damage outcomes were dissimilar and prone to subjectivity. It was difficult to ascertain superiority of any individual product.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Information on barrier protective efficacy, side effects and cost can be valuable to both clinicians and care providers. More randomized controlled trials on product effectiveness for prevention and treatment of IAD are highly recommended.<\/jats:p>\n <\/jats:sec>","DOI":"10.11124\/jbisrir-2016-003015","type":"journal-article","created":{"date-parts":[[2017,5,11]],"date-time":"2017-05-11T12:23:28Z","timestamp":1494505408000},"page":"1473-1496","source":"Crossref","is-referenced-by-count":30,"title":["Effectiveness of topical skin products in the treatment and prevention of incontinence-associated dermatitis: a systematic review"],"prefix":"10.11124","volume":"15","author":[{"given":"Priscilla","family":"Pather","sequence":"first","affiliation":[{"name":"Nursing Research Centre and The Queensland Centre for Evidence-Based Nursing and Midwifery: a Joanna Briggs Institute Centre of Excellence, Mater Health Services, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Hines","sequence":"additional","affiliation":[{"name":"Nursing Research Centre and The Queensland Centre for Evidence-Based Nursing and Midwifery: a Joanna Briggs Institute Centre of Excellence, Mater Health Services, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Kynoch","sequence":"additional","affiliation":[{"name":"Nursing Research Centre and The Queensland Centre for Evidence-Based Nursing and Midwifery: a Joanna Briggs Institute Centre of Excellence, Mater Health Services, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona","family":"Coyer","sequence":"additional","affiliation":[{"name":"School of Nursing, Queensland University of Technology (QUT), Brisbane, Australia"},{"name":"Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"12","key":"R1-20230825","first-page":"28","article-title":"Incontinence-related skin damage: essential knowledge","volume":"53","author":"Gray","year":"2007","journal-title":"Ostomy Wound Manage"},{"issue":"1","key":"R2-20230825","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/00152192-200701000-00008","article-title":"Incontinence-associated dermatitis: a consensus","volume":"34","author":"Gray","year":"2007","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"5","key":"R3-20230825","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1097\/WON.0b013e3181edac3e","article-title":"The incontinence-associated dermatitis and its severity instrument: development and validation","volume":"37","author":"Borchert","year":"2010","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"10","key":"R4-20230825","first-page":"46","article-title":"Perineal dermatitis risk factors: clinical validation of a conceptual framework","volume":"41","author":"Brown","year":"1995","journal-title":"Ostomy Wound Manage"},{"issue":"6","key":"R5-20230825","doi-asserted-by":"crossref","first-page":"1141","DOI":"10.1111\/j.1365-2648.2009.04986.x","article-title":"Prevention and treatment of incontinence-associated dermatitis: literature review","volume":"65","author":"Beeckman","year":"2009","journal-title":"J Adv Nurs"},{"issue":"3","key":"R6-20230825","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1097\/01.WON.0000270820.91694.1f","article-title":"Prevalence of incontinence and associated skin injury in the acute care inpatient","volume":"34","author":"Junkin","year":"2007","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"4","key":"R7-20230825","doi-asserted-by":"crossref","first-page":"42","DOI":"10.4037\/ccn2007.27.4.42","article-title":"Perineal dermatitis in critical care patients","volume":"27","author":"Driver","year":"2007","journal-title":"Crit Care Nurse"},{"issue":"(11 Suppl)","key":"R8-20230825","doi-asserted-by":"crossref","first-page":"56hn1","DOI":"10.1097\/01.NURSE.0000341725.55531.e2","article-title":"Beyond \u201cdiaper rash\u201d: Incontinence-associated dermatitis: does it have you seeing red?","volume":"38","author":"Junkin","year":"2008","journal-title":"Nursing"},{"issue":"(1 Suppl)","key":"R9-20230825","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1097\/00152192-200401001-00002","article-title":"Preventing and managing perineal dermatitis: a shared goal for wound and continence care","volume":"31","author":"Gray","year":"2004","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"6","key":"R10-20230825","doi-asserted-by":"crossref","first-page":"491","DOI":"10.2165\/11315950-000000000-00000","article-title":"Prevention and management of Incontinence-associated dermatitis","volume":"27","author":"Nix","year":"2010","journal-title":"Drugs Aging"},{"issue":"4","key":"R11-20230825","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1097\/WON.0b013e31822272d9","article-title":"MASD Part 2: Incontinence-associated dermatitis and intertriginous dermatitis: a consensus","volume":"38","author":"Black","year":"2011","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"3","key":"R12-20230825","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1097\/01.ASW.0000395037.28398.6c","article-title":"Incontinence and incontinence-associated dermatitis","volume":"24","author":"Langemo","year":"2011","journal-title":"Adv Skin Wound Care"},{"key":"R13-20230825","first-page":"75","article-title":"Etiology and pathophysiology of diaper dermatitis","volume":"3","author":"Berg","year":"1988","journal-title":"Adv Dermatol"},{"issue":"7","key":"R14-20230825","first-page":"1207","article-title":"Efficacy of chlorhexidine gluconate use in the prevention of perirectal infections in patients with acute leukemia","volume":"18","author":"Yeomans","year":"1991","journal-title":"Oncol Nurs Forum"},{"issue":"6","key":"R15-20230825","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1097\/WON.0b013e31822efe52","article-title":"A 3-in-1 perineal care washcloth impregnated with dimethicone 3% versus water and pH neutral soap to prevent and treat incontinence-associated dermatitis: a randomized, controlled clinical trial","volume":"38","author":"Beeckman","year":"2011","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"3","key":"R16-20230825","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1111\/bjd.12469","article-title":"Maintaining skin integrity in the aged: a systematic review","volume":"169","author":"Kottner","year":"2013","journal-title":"Br J Dermatol"},{"issue":"3","key":"R17-20230825","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/WON.0b013e3182549118","article-title":"Incontinence-associated dermatitis: consensus statements, evidence-based guidelines for prevention and treatment, and current challenges","volume":"39","author":"Doughty","year":"2012","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"1","key":"R18-20230825","first-page":"12","article-title":"Structured skin care regimen to prevent perineal dermatitis in the elderly","volume":"19","author":"Lyder","year":"1992","journal-title":"J ET Nurs"},{"issue":"2","key":"R19-20230825","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1097\/WON.0000000000000005","article-title":"Effect of a structured skin care regimen on patients with fecal incontinence: a comparison cohort study","volume":"41","author":"Park","year":"2014","journal-title":"J Wound Ostomy Continence Nurs"},{"issue":"3","key":"R21-20230825","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1097\/DCC.0b013e31820d25b1","article-title":"Innovative solutions: beds, baths, and bottoms: a quality improvement initiative to standardize use of beds, bathing techniques, and skin care in a general critical-care unit","volume":"30","author":"Eigsti","year":"2011","journal-title":"Dimens Crit Care Nurs"},{"issue":"8","key":"R22-20230825","doi-asserted-by":"crossref","first-page":"450, 452, 454\u20137","DOI":"10.12968\/bjon.2013.22.8.450","article-title":"Incontinence-associated dermatitis in the elderly: treatment options","volume":"22","author":"Corcoran","year":"2013","journal-title":"Br J Nurs"},{"issue":"1","key":"R23-20230825","doi-asserted-by":"crossref","first-page":"6, 8, 10\u20132","DOI":"10.12968\/bjcn.2013.18.1.6","article-title":"Moisture-associated skin damage: an overview for community nurses","volume":"18","author":"Voegeli","year":"2013","journal-title":"Br J Commun Nurs"},{"issue":"12","key":"R24-20230825","first-page":"51","article-title":"A comparison of cost and efficacy of three incontinence skin barrier products","volume":"50","author":"Zehrer","year":"2004","journal-title":"Ostomy Wound Manage"},{"issue":"5","key":"R25-20230825","doi-asserted-by":"crossref","first-page":"36","DOI":"10.11124\/01938924-201513050-00005","article-title":"The effectiveness of topical skin products in the treatment and prevention of incontinence-associated dermatitis: a systematic review protocol","volume":"13","author":"Pather","year":"2015","journal-title":"JBI Database Syst Rev Implement Rep"},{"key":"R26-20230825","first-page":"1","article-title":"National service framework for older people","year":"2001"},{"issue":"9","key":"R27-20230825","doi-asserted-by":"crossref","first-page":"920","DOI":"10.3109\/00365529709011203","article-title":"Stool form scale as a useful guide to intestinal transit time","volume":"32","author":"Lewis","year":"1997","journal-title":"Scand J Gastroenterol"},{"issue":"9","key":"R28-20230825","doi-asserted-by":"crossref","first-page":"398","DOI":"10.12968\/jowc.2004.13.9.27264","article-title":"Comparing cost per use of 3M Cavilon No Sting Barrier Film with zinc oxide oil in incontinent patients","volume":"13","author":"de Baatenburg","year":"2004","journal-title":"J Wound Care"},{"issue":"4","key":"R30-20230825","doi-asserted-by":"crossref","first-page":"214","DOI":"10.7257\/1053-816X.2012.32.4.214","article-title":"Prevention of incontinence-related skin breakdown for acute and critical care patients: comparison of two products","volume":"32","author":"Brunner","year":"2012","journal-title":"Urologic nursing"},{"issue":"(6 Suppl)","key":"R31-20230825","first-page":"S6, S8, S10 passim","article-title":"Comparison of two skin care regimes for incontinence","volume":"10","author":"Cooper","year":"2001","journal-title":"British journal of nursing (Mark Allen Publishing)"},{"issue":"12","key":"R32-20230825","doi-asserted-by":"crossref","first-page":"585","DOI":"10.12968\/bjcn.2014.19.12.585","article-title":"Evaluation of a skin barrier cream for managing IAD in elderly patients using high-frequency ultrasound","volume":"19","author":"Kerr","year":"2014","journal-title":"British journal of community nursing"},{"issue":"12","key":"R33-20230825","first-page":"44","article-title":"An evaluation of two incontinence skin care protocols in a long-term care setting","volume":"48","author":"Lewis-Byers","year":"2002","journal-title":"Ostomy Wound Manage"},{"issue":"6","key":"R34-20230825","first-page":"44","article-title":"Clinical and cost effectiveness of a cleanser protectant lotion for treatment of perineal skin breakdown in low-risk patients with incontinence","volume":"48","author":"Warshaw","year":"2002","journal-title":"Ostomy Wound Manage"},{"issue":"3","key":"R36-20230825","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1111\/1523-1747.ep12371796","article-title":"Ultrasound structure and digital image analysis of the subepidermal low echogenic band in aged human skin: diurnal changes and interindividual variability","volume":"102","author":"Gniadecka","year":"1994","journal-title":"J Invest Dermatol"},{"issue":"12","key":"R38-20230825","first-page":"46","article-title":"Incontinence-associated skin damage in nursing home residents: a secondary analysis of a prospective, multicenter study","volume":"52","author":"Zimmaro","year":"2006","journal-title":"Ostomy Wound Manage"},{"issue":"1","key":"R40-20230825","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/j.1365-2702.2006.01723.x","article-title":"A systematic review of topical skin care in aged care facilities","volume":"16","author":"Hodgkinson","year":"2007","journal-title":"J Clin Nurs"},{"issue":"5","key":"R41-20230825","doi-asserted-by":"crossref","first-page":"38","DOI":"10.7748\/nr2013.05.20.5.38.e312","article-title":"Randomised controlled trials: an introduction for nurse researchers","volume":"20","author":"Bench","year":"2013","journal-title":"Nurse Res"},{"issue":"3","key":"R42-20230825","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1002\/nur.21593","article-title":"A systematic review and meta-analysis of incontinence-associated dermatitis, incontinence, and moisture as risk factors for pressure ulcer development","volume":"37","author":"Beeckman","year":"2014","journal-title":"Research in nursing & health"}],"container-title":["JBI Database of Systematic Reviews and Implementation Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01938924-201705000-00018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T12:56:59Z","timestamp":1786453019000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01938924-201705000-00018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5]]},"references-count":37,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.11124\/jbisrir-2016-003015","relation":{},"ISSN":["2202-4433"],"issn-type":[{"value":"2202-4433","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5]]}}}