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107

Skin Injury Due To Incontinence: Multisite Case Studies Comparing Antifungal A with Antifungal B

Denise D. Lindhardt, RN, BSN, WOCN1, Laurie Carlyle, RN, BSN, WOCN1, Mary Ann Sammons, RN, BSN, CWOCN2, Laura Herbe, BSN, RN, CWOCN3, Toni Horton, RN, BSN, CCN4, Dasie Wilson, RNC, BS, MPA, CCCN, CWCN5, Laura Shafer, BSN, RNC, WOCN6, and Kelly Scoggins, RN, BSN, CWOCN6. (1) Wellstar Windy Hill LTAC, WOCN, 2540 Windy Hill Rd., Marietta, GA 30067, (2) Cleveland Clinic Foundation, WOCN, Cleveland, OH 44195, (3) Hillcrest Hospital - Cleveland Clinic Health System, Coordinator of Wound Center, 6801 Mayfield Road Suite 440, Mayfield Hts, OH 44124, (4) Hillcrest Hopsital, Wound Care, Mayfield Heights, OH 44124, (5) Crestwood Care Center, ET consultant, Joliet, IL 60155, (6) Gwinnett Medical System, WOCN, Lawrenceville, GA 30045

Clinical Problem: Patients experiencing both urinary and fecal incontinence have an increased risk for skin injury. If left untreated, both bacterial (Staphylococcus) and yeast (Candida albicans) infections may develop. This dermatitis can result in physical discomfort and added treatment cost.

Description of Past Management: When candidiasis and denudement are present an antifungal paste or ointment is used to protect and promote skin healing however, the paste products do not allow visibility of the skin leading to premature removal to assess the skin. Ointments allow visibility of the skin but do not adhere well to denudement.

Current Clinical Approach: These case studies compared a marketed antifungal ointment with a newly formulated clear antifungal specifically designed to provide moisture holdout while adhering to denuded skin. Five (5) clinical sites compared Antifungal A: a new clear antifungal with Antifungal B: a marketed antifungal ointment. Patients were entered into a case study if they had urinary or fecal incontinence and candidiasis with denudement. Each clinical evaluator was supplied designated packages, which identified the products as Antifungal A, or B. The patients were evaluated for a minimum of three (3) days to a maximum of ten (10) days.

Patient Outcomes: On assessment 3, four out of five (80%) of the patients using Antifungal A had resolution of satellite lesions and itching/burning: Two out of four (50%) of the patients using Antifungal B had resolution of satellite lesions and itching/burning indicating that Antifungal A may perform better than Antifungal B.

Conclusion: This group of comparative case studies indicates that Antifungal A may perform better than Antifungal B when used for candidiasis related to incontinence. The health care providers preferred Antifungal A, as it provided protection while allowing visual assessment of the skin.


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