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Are you effectively managing moisture to reduce the risk of Incontinence Associated Dermatitis?

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Incontinence Associated Dermatitis (IAD) is a common and painful problem.1 It affects all ages, races, and genders. Damage occurs when moisture from urine or stool is left on the skin.

What is IAD?

IAD is defined as skin inflammation manifested as redness with or without blistering, erosion, or loss of skin barrier function that occurs as a consequence of chronic or repeated exposure of the skin to urine or feces.3

• Perineal dermatitis• Perineal rash

• Nappy rash/dermatitis• Irritant dermatitis

Other definitions used to describe IAD1

• Moisture ulcers• Moisture lesions

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IAD can add over

of staff time per patient per day134 minutes

of community residents who suffer fecal incontinence2

of residents in long-term care (LTC) facilities241%

of incontinent patients in intensive care units2

of hospitalized adults2

83%

50%

42%

IAD is prevalent in up to

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Normal healthy skin is an effective barrier in preventing bacteria from entering the body. The normal acid mantle of the skin (pH 4 to 6.8) tends to inhibit the growth of bacteria.7

Bacteria are present on the skin, and if the skin is not broken, these bacteria do not enter.

However, bacteria and fungi can enter if the skin breaks down due to IAD.7

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IAD is painful—burning, itching and tingling in affected areas.1 Recent studies evaluating the effectiveness of skin care products reveal a direct association between pain intensity and the degree of skin damage from incontinence.2

Incontinence associated dermatitis can also lead to the loss of independence, disruption to activities and/or sleep, and reduced quality of life that becomes worse as the frequency and quantity of soiling increases.1

Patients with IAD can develop a pressure injury because excessive moisture reduces the skin’s tolerance to excessive pressure.

people develop pressure injuries in the U.S. each year9

2.5M+patients die as a direct result of a pressure injury each year9

60,000spent on individual patient care per pressure injury9

$20-150Kestimated yearly cost of treating pressure injuries in the United States 9

$9-11B

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• Blanchable erythema

• Glistening appearance of the skin due to serous exudate

• Partial thickness skin loss (denudation, erosion, abrasion or superficial ulceration of the injured skin)

• Viscles (bullae) containing clear exudate

Severity of damage is dependent upon:2

• Aging skin is particularly vulnerable to IAD due to lower baseline function and prolonged healing

• Duration of irritant exposure

• Frequency of exposure

• Type of irritant (double incontinence and liquid stool are most caustic). Double incontinence is 50-70% more common than urinary or fecal incontinence alone1,8

Clinical characteristics of IAD1

Subject with IAD.

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Comparing moisture management product solutions

Lack air-permeability (skin microclimate).

Moisture vapor permeable film allows moisture vapor to transfer away from the patient while protecting bed linens from bodily fluids, helping to keep the patient dry and comfortable.

Traditional features Premium features

Reusable linen or standard underpads (or “chucks”) lack the absorbent capacity to manage large or multiple voids and may trap moisture against the skin.

Reusable linen product may struggle to lock moisture away, holding fluid against the skin.

These products may leak, unable to contain voids.

Dual action core is designed to quickly lock in fluids and neutralize unpleasant odors.

Backsheet assists in the lift and repositioning of patients up to 400 pounds, which helps reduce the need for drawsheets and reusable underpads.

Standard underpads may tear.

Care providers may layer multiple products. Place only one premium underpad under the patient at a time.

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Cardinal Health™ Premium Underpads To manage incontinence

Wings™ Quilted Premium XXL Underpad 400 lb. weight claim

Ordering information

Cat. No. Description Packaging HCPCS‡

P2336C Maximum absorbency, 23 x 36 in. 12ea/bg, 6 bg/cs T4541

P3030C Maximum absorbency, 30 x 30 in. 10ea/bg, 6 bg/cs T4541

P3036C Maximum absorbency, 30 x 36 in. 10ea/bg, 4 bg/cs T4541

Ordering information

Cat. No. Description Packaging HCPCS‡

PXXL Maximum absorbency, 40 x 57 in. 5ea/bg, 6 bg/cs T4541

Wings™ Quilted Premium Strength Underpad 375 lb. weight claim

Ordering information

Cat. No. Description Packaging HCPCS‡

P2336PS Maximum absorbency, 23 x 36 in. 12ea/bg, 6 bg/cs T4541

P3030PS Maximum absorbency, 30 x 30 in. 10ea/bg, 6 bg/cs T4541

P3036PS Maximum absorbency, 30 x 36 in. 10ea/bg, 4 bg/cs T4541

Wings™ Quilted Premium Comfort Underpad 300 lb. weight claim

Ordering information

Cat. No. Description Packaging HCPCS‡

P2336MVP Maximum absorbency, 23 x 36 in. 12ea/bg, 6 bg/cs T4541

P3030MVP Maximum absorbency, 30 x 30 in. 10ea/bg, 6 bg/cs T4541

P3036MVP Maximum absorbency, 30 x 36 in. 10ea/bg, 4 bg/cs T4541

Wings™ Quilted Premium MVP Underpad

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A solution to managing moisture incontinence:

Strong enough to lift and reposition up to 400 lbs. with breathable backsheet technology

Cardinal Health™ Premium UnderpadsRepositioning, maximum* absorbency

Breathable backsheet technology

Soft top sheet helps to increase patient comfort

Maximum absorbency with a super absorbent core to wick away

fluid from skin and contain voids

Promotes healthy skin Not made

with natural rubber latex

Basic Light

Extra Moderate

Plus Heavy

Ultra Extra heavy

Super/premium Maximum

Overnight Night time *Absorbency levels within our own product line.

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Ordering information

Cat. no. Description Packaging HCPCS‡

UPR3036 Repositioning pad, maximum absorbency, light green, 30 x 36 in. 10 ea/bg, 4 bg/cs A4554

Our maximum offering

Ordering information

Cat. no. Description Packaging HCPCS‡

UPPM1824 Maximum absorbency, teal, 24 x 18 in. 10 ea/bg, 9 bg/cs A4554

UPPM2436 Maximum absorbency, teal, 36 x 24 in. 10 ea/bg, 6 bg/cs A4554

UPPM3136 Maximum absorbency, teal, 36 x 31 in. 10 ea/bg, 4 bg/cs A4554

Extra absorbency

Ordering information

Cat. no. Description Packaging HCPCS‡

UPPMX2436 Extra absorbency, white, 24 x 36 in. 5 ea/bg, 14 bg/cs A4554

UPPMX3036 Extra absorbency, white, 30 x 36 in. 5 ea/bg, 14 bg/cs A4554

Cardinal Health™ Premium UnderpadsTo manage moisture incontinence.

Repositioning, maximum absorbency

RN best practice

• Interactive learning platform designed to encourage best practices and promote knowledge and skill development among nurses and others who provide day-to-day patient care

• Earn CME credits and certificates from ~20 courses

www.rnbestpractice.com

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© 2018 Cardinal Health. All Rights Reserved. CARDINAL HEALTH, the Cardinal Health LOGO and WINGS are trademarks or registered trademarks of Cardinal Health and may be registered in the US and/or in other countries. Lit. No. 2PATR18-785140 (08/2018)

cardinalheatlh.com

Average incontinence associated dermatitis severity score

Aver

age

IAD

S sc

ore

Disposable pad

Reusable pad

0

0.5

1

1.5

2

2.5

3

3.5

4

Percentage of patients with incontinence associated dermatitis

Perc

enta

ge o

f pat

ient

sDisposable

pad n=92

Reusable pad n=98

0%

10%

20%

30%

40%

50%

60%

EvaluationFor a period of four months, each unit evaluated the Cardinal Health premium underpads.

This evaluation was conducted independent of Cardinal Health employee participation.

Large IDN in the Eastern United States improves skin health

As part of a program to improve skin health, Cardinal Health premium underpads were evaluated by a large IDN in the Eastern United States.

The evaluation occurred on three units and lasted four months.

The IDN team commissioned biostatisticians to review their results.

1 Ousey K, O’Connor L. (2017). Incontinence-Associated Dermatitis Made Easy. Wounds UK.

2 Ermer-Seltun, J. (2011). Practical Prevention and Treatment of Incontinence-Associated Dermatitis — a Risk Factor for Pressure Ulcers. Ostomy Wound Management.

3 Beeckman D, Verhaeghe S, et. al. (2016). Interventions for Preventing and treating Incontinence-Associated Dermatitis in Adults. Cochrane Database Systematic Reviews.

4 Milne C, Motta G, Wendling S. (2017). Impact of an Absorbent Underpad on the Prevention and Improvement of Incontinence Associated Dermatitis in SNF Residents. Poster presented at WOCN conference.

5 Beeckman D. (2016). Pressure Ulcers and Incontinence-Associated Dermatitis (IAD): Etiology and Prevention. Symposium conducted at EUPAP.

6 Newman D. (2012). Independent Study Monograph II: Skin Care and Use of Products and Devices.

7 Langemo D, Hanson D, Hunter S, et al. (2011). Advances in Skin & Wound Care. The Journal for Prevention and Healing.

8 Customer case study. Data and references on file.

9 Preventing Pressure Ulcers in Hospitals. Content last reviewed October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/pressureulcertoolkit/index.html

10 Cardinal Health, documents available upon request

Case study10

Pre-evaluation statePrior to the study, reusable underpads were used on three hospital units.

Post-evaluation stateAfter moving from reusable underpads to Cardinal Health premium underpads, the team of biostatisticians uncovered statistically significant reductions in IAD severity scores and IAD prevalence among their patients (p = 0.002).

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‡ The reimbursement information provided herein is based on published information and is intended for illustration purposes only. The information provided herein is in no way intended to provide customer with reimbursement recommendations or guidance. Customer should verify any coding, charge, and payment levels with the appropriate third party payor before seeking reimbursement.