Absorbent Briefs Containing Curly Fiber Lower (Acidify) Skin pH Reducing Risk for Incontinence Associated Skin Damage in Older Nursing Home Residents

Background:  Alkaline skin pH is a risk factor for incontinence associated skin damage (IASD).  A more acidic skin pH reduces risk of IASD and may benefit incontinent adults.

 Purpose: To compare the pH of skin 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: Using an experimental design, skin pH was measured in duplicate using a pH meter and flat-tipped probe on six areas of the right and left inner thighs and six areas of the right and left inner forearms; each area was exposed to one of six conditions, randomly ordered. Experimental conditions:  (A) an absorbent brief containing curly fiber wet with an alkaline solution mimicking urine/fecal pH and (B) a wet standard brief (without curly fiber). Control conditions: (C) normal skin, (D) dry brief containing curly fiber, (E) dry standard brief, (F) alkaline solution only. Differences in pH were analyzed using ANOVA; post- hoc comparison p-values were adjusted using Tukey’s test.  

 Results: 26 NH residents (77% female, all White, aged 87(6) (mean(sd)), 69% with only urinary, 31% with urinary+fecal incontinence) had their skin pH measured. On the thighs, the skin pH (mean(sd)) after A (wet brief+curly fiber) =5.7(0.5) was less than the pH after B=6.4(0.5), C=6.6(0.4), D=6.5(0.4), E=6.6(0.5), and F=6.4(0.4). On the forearms, the skin pH after A=5.3(0.4) was less than the pH after B=6.0(0.4), C=6.0(0.5), D=6.1(0.6), E=6.0(0.4), and F=5.9(0.4) (p<.001 for all comparisons to A). No other differences were significant. 

 Conclusions: Absorbent briefs containing curly fiber significantly lower/acidify pH of skin exposed to an alkaline solution with pH 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 NH residents.