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Epidemiology of Incontinence-Associated Dermatitis and Intertriginous Dermatitis (Intertrigo) in an Acute Care Facility

Arnold-Long, Mary; Johnson, Emily

Journal of Wound Ostomy & Continence Nursing: May/June 2019 - Volume 46 - Issue 3 - p 201–206
doi: 10.1097/WON.0000000000000519
Wound Care

PURPOSE: The purpose of this study was to measure the prevalence of incontinence-associated dermatitis (IAD) and intertriginous dermatitis (ITD) upon admission, and the incidence of hospital-acquired IAD and ITD in a sample of acutely ill adults.

DESIGN: This was a descriptive, retrospective-cohort observational study.

SUBJECTS AND SETTING: The sample comprised 417 adults admitted to an urban community hospital licensed for 249 acute and 52 acute rehabilitation beds in Charleston, South Carolina, and referred to WOC nurses for evaluation and treatment.

METHODS: Prevalence and incidence rates were calculated from data previously collected for quality improvement purposes from January 1, 2014, to December 31, 2016, by the WOC nurses and documented in a secure, password-protected electronic spreadsheet. The prevalence of IAD/ITD was calculated as the proportion of patients diagnosed with IAD/ITD on admission to our facility. The incidence of IAD and ITD was calculated as percentage of patients who developed IAD/ITD during the course of their hospital stay. All units in the hospital were included.

RESULTS: The mean prevalence of IAD present on admission was 16%; the prevalence decreased over the data collection period; it was 21% in 2014, 15% in 2015, and 13% in 2016. The mean incidence of hospital-acquired IAD during the data collection period was 23%; the highest rate (26%) occurred in 2016. Patients classified as normal weight from their body mass index and patients 60 years and older had the highest incidence of hospital-acquired IAD. The mean prevalence of ITD for patients admitted to the hospital was 40% for the 3-year time; annual rates varied from a low of 36% in 2015 to a high of 42% in 2016. The mean incidence of hospital-acquired ITD was 33% over the data collection period; mean incidence rates were 32% in 2014, 39% in 2015, and 29% in 2016. The incidence of ITD was higher in patients classified as obese based on body mass index in patients 60 years and older. The most common location was the gluteal cleft.

CONCLUSIONS: The prevalence of IAD fell within the range of prior epidemiologic studies, but the facility-acquired IAD incidence rates were higher than other studies based in the acute care setting. The prevalence of ITD was higher than rates reported in prior studies; we searched the literature and found no previous reports of ITD occurrences over the course of a hospital stay. Additional research regarding IAD prevention and ITD in the gluteal cleft is needed. Data collection regarding IAD and ITD prevalence and incidence could be incorporated into the data collection tool used for pressure injury data collection for the National Database of Nursing Sensitive Indicators.

Mary Arnold-Long, DNP, APRN, CRRN, CWOCN-AP, ACNS-BC, WOConsultation, LLC.

Emily Johnson, PhD, Medical University of South Carolina, Charleston.

Correspondence: Mary Arnold-Long, DNP, APRN, CRRN, CWOCN-AP, ACNS-BC, WOConsultation, LLC (

The authors declare no conflicts of interest.

© 2019 by the Wound, Ostomy and Continence Nurses Society.