Study On New Skin Products For Severe Stroke Patients With Incontinence-associated Dermatitis

Objective: To compare the effects of barrier film,silicone dressings alone or combined with ostomy powder on treatment of severe stroke patients with incontinence-associated dermatitis and to provide the theoretical basis for the establishment and implementation of the structured nursing program for the patients with incontinence-associated dermatitis.Methods: From 2015 January to 2016 March,in the Department of Neurology,the Second Hospital of Hebei Medical University,120 cases of severe stroke patients with incontinence-associated dermatitis are chosen as the research objects,and randomly divided Group A,B,C and D,respectively.Apart from identical skin care in all groups,for Group A,silicone dressing on perineal skin was applied once every 12h;for Group B,silicone dressing and ostomy powder were applied once every 12h;for Group C,barrier film on perineal skin was applied once every 12h;for Group C,barrier film and ostomy powder were applied once every 12h;Comparison of Four groups of patients in age,gender,state of consciousness,type of incontinence and incontinence frequency,perineal assessment tool(PAT)score and severity of incontinence-associated dermatitis shows no significant difference(P > 0.05).Compare the three indicators of the curative effect,healing time and nursing cost of incontinence-associated dermatitis.Adopt SPSS19.0 to conduct statistical analysis,carry out normality and homogeneity of variance test to the materials,conduct analysis of variance upon the healing time and nursing cost of incontinence-associated dermatitis.The efficiency was evaluated by rank sum test.Results:1 The basic characteristics of the investigation objects120 cases were severe stroke patients with dermatitis,including 71 males and 49 females,aged 45-83 years.The results showed that there were no statistical difference(P> 0.05)in age,gender,state of consciousness,type of incontinence and incontinence frequency,perineal assessment tool(PAT)score and severity of incontinence-associated dermatitis of the patients.2 Comparison of the efficacy of IAD in 4 groups of patientsThe differences about cure rate and effective rate in 4 groups had no statistical significance(P>0.05).3 Comparison of the healing time of IAD in 4 groups of patientsThe shortest average healing time of IAD in 4 groups of patients was group B(silicone dressings combined with ostomy powder)(4.02±0.53)days,followed by group A(silicone dressings)(4.63±1.21)days,group C(barrier film combined with ostomy powder)(4.81±1.52)days,the longest was group D(barrier film)(5.62±2.07)days.Comparative differences in 4 groups was statistically significant(F=7.760,P<0.001).Comparison of the average healing time of IAD in group A and group B,group A and group C,the differences were no statistically significant(P>0.05).Comparison of the average healing time of IAD in group A and group D,group B and group C,group B and group D,group C and group D,the differences were statistically significant(P<0.05).4 Comparison of the nursing cost of IAD in 4 groups of patientsThe highest average nursing cost of IAD in 4 groups of patients was group B(silicone dressings combined with ostomy powder)(447.6±43.4)RMB,followed by group A(silicone dressings)(415.3±52.6)RMB,group C(barrier film combined with ostomy powder)(318.2±36.1)RMB,the lowest was group D(barrier film)(265±44.5)RMB.Comparative differences in 4 groups were statistically significant(F=160.81,P<0.001).Further comparisons showed that there were significant differences between every two groups(P <0.05).Conclusion:The effect of silicone dressings on treatment of severe stroke patients with IAD was better than the effect of barrier film,but the higher nursing cost.