Dermatologic Effects and Management of Urine and Feces on Infant and Adult Skin.
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Date
2014-07-01
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Abstract
The effect of urine and feces on the skin is a contributing factor to the development of
incontinent and diaper dermatitis. The objective of this research was to evaluate skin
effects of a given urine or fecal sample on the donor child and/or an adult caregiver, both
of whom would be exposed to the biological material in course of daily life.
Methods: Urine was evaluated under a variety of experimental skin conditions: normal
(N), compromised by tape stripping (C), hydrated by prolonged exposure to water via
occlusive patch (H), and hydrated/compromised (H/C). After pre-treatment, sites were
patched (3 times of 24-h each) with 0.5 ml infant urine, saline (negative control) or 0.3%
sodium lauryl sulfate (SLS, positive control). Fecal material was evaluated using a 4-h
patch followed by tape stripping of selected sites.
Results: In the urine study, a single 24-h patch produced a significant elevation of pH
compared to both the negative (saline) and positive (sodium lauryl sulfate) controls for all
experimental skin conditions. Erythema produced by urine was intermediate between the
negative and positive controls, and significantly different from the negative control on the
N and C skin test sites. All three materials produced an increase in hydration of the skin.
The single 4-h patch of fecal material produced significant erythema, a significant
elevation of pH, and a significant increase in TEWL. Recovery to pre-treatment levels
was observed by the next day on sites that received no further treatment. However, on
sites patched with fecal material, then further compromised by tape stripping, recovery to
pre-treatment levels for erythema and TEWL were delayed.
Conclusion: These studies indicate that urine appears to have an inherent low level irritant property when in continuous contact with skin for 24 to 48 hours. With relatively
short exposures of 4 hours fecal material causes visible erythema, increases in pH and
TEWL, and decreases in stratum corneum resilience to the subsequent insult of tape
stripping. Results re-inforce the utility of modern diapers and incontinent products,
utilizing superabsorbent materials, to effectively absorb wetness, keeping skin dryer and
minimizing adverse skin effects.
Description
Keywords
Diaper dermatitis, incontinent dermatitis, fecal incontinence, urinary incontinence, Urine, Feces, Skin pH, TEWL, chemical composition, occlusion
Citation
Farage Miranda A, Tzeghai Ghebre, Miller Kenneth W, Tepper Bruce, Connor Rob O, Qin Wendy, Odio Mauricio. Dermatologic Effects and Management of Urine and Feces on Infant and Adult Skin. British Journal of Medicine and Medical Research. 2014 July; 4(19): 3671-3688.