Skin is a very important organ of the body, apart from being the largest. And it requires good caring and nurturing. A small cut or rash does hurt, doesn’t it? So, we really need to keep our skin in good condition and this is particularly applicable to those who have very fragile skin or who are constantly exposed to moisture which can have a debilitating effect on the skin. Elderly people have to be extra careful because as we grow older, the skin becomes thinner and less elastic. Hence, it is more exposed to skin damage and can easily be injured.
Incontinence is one of those conditions whose long-term sufferers are most likely to encounter skin problems. Continuous exposure to urine and feces is one of the most common causes of skin breakdown. The chemical present in these waste products has an effect on the skin making it fragile and causing it to break and injure easily. Feces, in particular, can break down the skin because residual enzymes and bacteria are present in them. Fecal bacteria may pierce the skin escalating the risk of secondary infection.
Skin care for incontinent patients becomes exceptionally crucial, particularly in the region around the buttocks, hips, genitals and the area between the pelvis and rectum.
Because of excess moisture in these areas, there is a likelihood of redness, peeling, irritation and yeast infections the result of which are bedsores or pressure sores. It is advisable to seek immediate medical attention on first spotting redness or sores on the skin because pressure ulcers can lead to serious infection or tissue death if not attended to urgently. And in such a case, they can take some months to heal completely causing a lot of discomfort and pain. Bed sores may also develop in malnourished people, those who are immobile and confined to the bed or chair all day long and also in those who have had radiation therapy in that region. And people with dry skin have to be extra cautious because dry skin is almost a breeding ground for germs.
Urine is alkaline in nature and its pH ranges from 4.5 to 8.0. This alkaline characteristic is damaging to the skin especially if urine is in contact with the body for a long period of time. In such a case, the skin becomes more prone to friction and erosion because the urine changes the normal skin flora and increases the permeability of the stratum corneum.
When urine comes in contact with the hydrolipid film, which is the skin’s protective layer, the risk of bacterial infection increases because the skin becomes more porous to germs and is easily injured by even slight friction or shearing. Exposure to ammonia in urine leads to the growth of bacterial colonization on the skin apart from burning and irritation. Urine skin burn can be painful and troublesome to get rid of.
Impaired skin integrity related to incontinence can be the result of following conditions:
Special perineal skin care for the incontinent patients is essential because they are required to wear diapers at all times. Their skin needs to be kept clean and dry all the time.
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Check the skin daily for redness, rash or skin breakdown from urine. If redness is present, press it to see if it turns white. If it does not, then consult a doctor immediately. Warning signs include skin that is pink, bright red, burned, irritated, or chafed.
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Razia Sanwari is a journalist by profession with more than 20 years of experience in the print media. With a Masters's in English Language and Literature, Razia began her career as a junior editor in a Kolkata English language daily ...
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