A Risk Factor For Pressure Ulcers
IAD is defined as "an inflammation of the skin that occurs when urine or stool comes into contact with perineal or perigenital skin."1 IAD is also a major risk factor for pressure ulcers.2
IAD is often grouped with pressure ulcers, but they are not one and the same. A pressure ulcer is defined as "any lesion caused by unrelieved pressure resulting in damage of underlying tissue."3 Essentially, skin damage from a pressure ulcer occurs from the inside out, but IAD starts on the surface and works inward.
Therefore, "IAD should be distinguished from wounds caused by differing etiologies, such as full-thickness wounds (caused by pressure and shear) or linear lesions (caused by a skin tear)."1
IAD RISK FACTORS:1
- Fecal incontinence
- Frequency of incontinence
- Poor skin condition
- Pain
- Poor skin oxygenation
- Fever
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- Compromised mobility
- Double (urinary and fecal) incontinence
- Tissue tolerance impairments
- Moisture
- Alkaline pH
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"...Patients with fecal incontinence were 22 times more likely to have pressure ulcers than patients without fecal incontinence."2
"...The odds of having a pressure ulcer were 37.5 times greater in patients who had both impaired mobility and fecal incontinence than in patients who had neither."2
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IAD PREVALENCE
Studies at long-term care facilities show IAD prevalence can range from 5.6% to 50%, while incidence rates range from 3.4% to 25%. 1 In acute care, one 976-patient study found 20.3% of patients were incontinent.3,4 IAD prevalence for incontinent patients was 54% at three hospitals, affecting 11% of the general patient population. 4,5
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IAD'S COSTLY CONSEQUENCES
The true cost of IAD is not yet known, but it is likely to be grouped with costs for other skin injuries such as pressure ulcers. 1
- Each year, the average hospital incurs $400,000 to $700,000 in direct costs to treat pressure ulcers.6
- Just one complex, full-thickness pressure ulcer can cost as much as $70,000 to heal, while less serious pressure ulcers cost between $2,000
and $30,000.7
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