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



• 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.

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