Absorbent Briefs Containing Curly Fiber Lower Acidify Skin

Absorbent Briefs Containing Curly Fiber Lower (Acidify) Skin p. H Reducing Risk for Incontinence Associated Skin Damage in Older Nursing Home Residents Donna Z. Bliss, Ph. D, RN, FAAN, FGSA, Peggy Bland, RN, HSD, Kjerstie Wiltzen, BA, BSN, CWCN, Alexandra Gannon, Anna Wilhelms, Michelle Mathiason, MSN, and Robert Turnbaugh, RN, University of Minnesota School of Nursing, Minneapolis, MN, and Presbyterian Manor, Farmington, MO Figure 1. Skin p. H Results Introduction • Alkaline skin p. H increases the risk of developing incontinence associated skin damage (IASD). • Skin p. H of older adults is more alkaline than younger adults. • Leaked urine or feces can make skin p. H more alkaline. • A more acidic skin p. H reduces risk of IASD and may benefit incontinent adults. Purpose • To compare the p. H of skin p. H of older (75+ years) incontinent nursing home (NH) residents exposed to an absorbent brief with and without curly fiber wet with an alkaline solution and to various control conditions. Methods • Experimental design. • Skin p. H was measured on • 6 areas of the right and left inner thighs • 6 areas of the right and left inner forearms. • Each area was exposed to 1 of 6 conditions for the same time in random order: • Experimental conditions: § an absorbent brief containing curly fiber wet with an alkaline solution § A industry standard brief (without curly fiber) wet with an alkaline solution • Control conditions: § dry brief containing curly fiber § dry standard brief § alkaline solution only § normal skin 7 6. 5 • p. H measures were made in duplicate with a flattipped p. H probe and p. H meter • An alkaline solution (p. H ~7. 5) mimicking p. H of urine/feces was made using distilled water, sodium chloride, 25% ammonia and/or distilled white vinegar • Differences in p. H were analyzed by ANOVA; Tukey’s test adjusted for post- hoc comparisons of p-values • Residents or their legal representatives provided informed consent Sample characteristics • n = 26 nursing home residents without skin damage • 77% female, White, age = 87 (6) years (mean (sd)) • Only urinary incontinence = 69% of subjects § Urinary+fecal incontinence = 31% • Short term memory problem = 19% of subjects § Long-term memory problem = 23% • Moderate deficits in activities in daily living § Score = 15. 5 (6. 9) (mean (sd)); possible range = 0 -28 Results • On both the thighs and forearms, the skin p. H after A (curly fiber + brief wet with alkaline solution) was significantly lower (more acidic) than the skin p. H after all other conditions (See Figure 1). • No other differences were statistically significant. • No skin damage occurred in any subject. • Order of p. H testing had no effect on results. p. H 6. 44 6. 03 6 6. 52 6. 56 6. 55 6. 41 6. 11 6. 01 5. 96 5. 92 5. 67 5. 5 5. 32 Fore Arm Thigh 5 Brief with Standard brief Distilled water Dry brief with Dry standard curly fiber wet without curly on normal curly fiber brief without with alkaline fiber wet with skin curly fiber solution alkaline solution Alkaline solution on skin ANOVA F=8. 83 for thigh and F=10. 12 forearm p. H differences, p <. 001 for both; in post-hoc comparisons, skin p. H values after wet brief with curly fiber are lower than all other conditions (p=. 001 for all) Conclusions • Absorbent briefs containing curly fiber significantly lower/acidify p. H of skin exposed to an alkaline solution with p. H similar to urine/feces while standard briefs do not. • Absorbent briefs containing curly fiber have potential to prevent IASD, reduce IASD severity, and promote IASD healing in older nursing home residents. • Findings support use of absorbent briefs with curly fiber as a new strategy for combating IASD and maintaining skin health during incontinence. Acknowledgements This study was funded by a research grant from Hartmann. The absorbent briefs used were Dignity® briefs (industry standard) and Dignity® briefs with Curly fiber. XLIT 2338 Rev. 0 (0416)