King's College London

Researchers in the Faculty of Nursing, Midwifery & Palliative Care are investigating how the treatment and prevention of incontinence-associated dermatitis (IAD) might be improved in the UK. They have been awarded funding to develop and test a manual and care package for the prevention and treatment of IAD that can be delivered by health professionals and care givers.

IAD is skin damage caused by repeated contact with urine, faeces or both. It causes pain, discomfort, infections and pressure sores. 14 million UK people have urinary incontinence and 6.5 million have bowel problems, but the number with IAD in the UK has not been reliably established. It may affect as many as 51% of people with incontinence living at home and up to 30% in nursing and residential care.

Currently, there are no specific guidelines for IAD management. Prevention and treatment involve skin cleansing and use of products to protect the skin, alongside continence promotion and correct use of incontinence pads. Many people provide this care, such as family carers, nurses and unregistered care workers. The research team estimate the risk of developing IAD could be halved using preventative measures.

The research, funded by the National Institute for Health Research (NIHR), is being led by Dr Sue Woodward in the Faculty of Nursing, Midwifery & Palliative Care at King’s College London, alongside researchers from University of Southampton and international consultants from the European Pressure Ulcer Advisory Panel. Dr Woodward and some of her collaborating colleagues had co-authored the Cochrane Review Interventions for preventing and treating incontinence-associated dermatitis in adults in 2016, which contributed to this research being funded.

The team will work with people with IAD, their carers and health professionals to develop and test the manual and training package, which will guide the prevention and treatment of IAD in care homes and people’s own homes. The research includes investigating what might help or stop people using the manual and develop a plan to introduce it into care homes and the community.

The team will also be working with these groups to design a future study which will test if the manual works and can be successfully introduced into a real-world setting. They will conduct a small-scale trial to test the feasibility of the future study, working with a small sample of care homes and care home agencies over six months.

About the NIHR:

The National Institute for Health Research (NIHR) is the nation's largest funder of health and care research. The NIHR:

• Funds, supports and delivers high quality research that benefits the NHS, public health and social care
• Engages and involves patients, carers and the public in order to improve the reach, quality and impact of research
• Attracts, trains and supports the best researchers to tackle the complex health and care challenges of the future
• Invests in world-class infrastructure and a skilled delivery workforce to translate discoveries into improved treatments and services
• Partners with other public funders, charities and industry to maximise the value of research to patients and the economy

The NIHR was established in 2006 to improve the health and wealth of the nation through research, and is funded by the Department of Health and Social Care. In addition to its national role, the NIHR commissions applied health research to benefit the poorest people in low- and middle-income countries, using Official Development Assistance funding.