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Incontinence-Associated Dermatitis: Consensus Statements, Evidence-Based Guidelines for Prevention and Treatment, and Current Challenges

Doughty, Dorothy; Junkin, Joan; Kurz, Peter; Selekof, Joan; Gray, Mikel; Fader, Mandy; Bliss, Donna Z.; Beeckman, Dimitri; Logan, Susan

Journal of Wound, Ostomy and Continence Nursing: May/June 2012 - Volume 39 - Issue 3 - p 303–315
doi: 10.1097/WON.0b013e3182549118

In 2010, an international consensus conference was held to review current evidence regarding the pathology, prevention, and management of incontinence-associated dermatitis (IAD). The results of this literature review were published in a previous issue of this Journal. This article summarizes key consensus statements agreed upon by the panelists, evidence-based guidelines for prevention and management of IAD, and a discussion of the major challenges currently faced by clinicians caring for these patients. The panelists concur that IAD is clinically and pathologically distinct from pressure ulcers and intertriginous dermatitis, and that a consistently applied, structured, or defined skin care program is effective for prevention and management of IAD. They also agreed that differential assessment of IAD versus pressure ulceration versus intertriginous dermatitis remains a major challenge. Panel members also concur that evidence is lacking concerning which products and protocols provide the best outcomes for IAD prevention and treatment in individual patients. Issues related to differential assessment, product labeling and utilization, staff education, and cost of care are the primary focus of this article.

Dorothy Doughty, MSN, Director of Emory University WOC Nursing Education, WOC Nursing Education Center, Emory University, Atlanta, Georgia.

Joan Junkin, MSN, RN, CWOCN, Wound Consultant at The Healing Touch, Bryan LGH Medical Center, Lincoln, Nebraska.

Peter Kurz, WPM Wund Pflege Management, Managing Director, Graduate Nurse for Wound Management, Vienna, Austria.

Joan Selekof, BSN, RN, CWOCN, Coordinator -Wound Ostomy Continence Nursing, University of Maryland Medical Center, Columbia.

Mikel Gray, PhD, FNP, PNP, CUNP, CCCN, FAANP, FAAN, Professor and Nurse Practitioner, University of Virginia Department of Urology and School of Nursing, Charlottesville.

Mandy Fader, PhD, Research Fellow, University College London, Centre for Clinical Technology & Science, London, England.

Donna Z. Bliss, PhD, RN, FAAN, Research Professor, University of Minnesota School of Nursing, Minneapolis.

Dimitri Beeckman, PhD, RN, SEANS, Assistant Professor, University of Ghent, King's College London and Florence Nightingale School of Nursing & Midwifery, London, England.

Susan Logan, BSN, RN, CWS, FACCWS, Clinical Consultant, Kindred Healthcare, Inc, Louisville, Kentucky.

Correspondence: Dorothy Doughty, MSN, Emory University WOC Nursing Education Program, 1762 Clifton Rd NE Ste 2200, Atlanta, GA 30322 (

The authors declare no conflict of interest.

Copyright © 2012 by the Wound, Ostomy and Continence Nurses Society