Urine and/or fecal incontinence in an adult is a risk factor for pressure ulceration. Certain findings can help identify a patient who may benefit from more aggressive management.
Factors influencing the skin changes in the incontinent adult:
(1) amount of urine leakage
(2) amount of fecal leakage
(3) prolonged skin exposure to urine and/or feces
(4) mobility
(5) disability for activities of daily living
Risk factors for skin ulceration:
(1) development of blanchable erythema, especially if extensive
(2) impaired mobility, especially in patients spending a large amount of time in bed
(3) prolonged exposure to significant moisture
(4) frequent incontinence
where:
• Nonblanchable erythema is the first stage for pressure ulceration.
• Blanchable erythema blanches under finger pressure but promptly returns to a reddish hue when the pressure is released.
• An adult diaper can reduce the amount of moisture that the skin is exposed to if it is changed when soiled.
• The type of incontinence will affect which portions of the skin are affected.
The presence of blanchable erythema identified a patient who should be targeted for prevention, especially when other risk factors are present.
