Introduction
An important function of the skin is to act as a barrier to moisture, irritants and bacteria. Maintenance of the skin’s integrity and preservation of its barrier function is a critical nursing responsibility to prevent potentially complex concerns, like Incontinence-Associated Dermatitis (IAD) and other types of Moisture-Associated Skin Damage (MASD; Fletcher et al, 2020).
The term IAD refers to skin breakdown caused by exposure to urine or faeces, while MASD is an umbrella term referring to damage caused by prolonged exposure to moisture from incontinence, exudate, stoma effluent, perspiration, or other bodily fluids (Fletcher et al, 2020).
IAD can be expensive and time-consuming to treat; as well as being painful and debilitating for patients, it is associated with reduced quality of life (Fletcher et al, 2020; Raepsaet et al, 2021). Moreover, the presence of IAD leads to a greater likelihood of developing pressure ulcers due to increased susceptibility to damage from extrinsic factors such as pressure, friction and shearing (Freitas, 2021).
Management of potential skin breakdown requires the use of skin barrier products, such as Medi Derma-PRO Skin Protectant Ointment and Medi Derma-PRO Foam & Spray Incontinence Cleanser, which are part of the Total Barrier Protection Strategy from Medicareplus International (Freitas, 2021).
How It Works: Medi Derma-PRO Cleanser and Ointment
Combined use of Medi Derma-PRO Cleanser and Ointment provides maximum barrier protection on moderate to severe skin damage associated with incontinence, exudate and periwound maceration to prevent the breakdown of skin. Starting Medi Derma-PRO at the first signs of further skin excoriation will improve clinical outcomes and enhance the patient’s quality of life. Most clinicians in the UK rely on Medi Derma-PRO for both adult and paediatric/neonatal skin care and have them listed on their pathways.
Medi Derma-PRO Cleanser [See Figure 1] gently cleanses the skin in incontinence and wound care before applying Medi Derma-PRO Ointment or other barrier products like Medi Derma-S Barrier Cream or Medi Derma-S Barrier Film.
It effectively removes even dried-on bodily fluids, such as urine, faeces, blood, exudate, or any residual barrier product. As a no-rinse and non-sting formulation, it minimises skin rubbing and potential friction damage, enhancing patient comfort.
The cleanser has been designed as an ergonomic spray bottle with foam and spray modes for ease of use:
- a spray, which is suitable for lighter soiling, and
- a foam that stays on the skin more easily, for use on heavy soiling and difficult-to-reach areas (refer to Instructions for Use)
Medi Derma-PRO Ointment [See Figure 2] forms a long-lasting, resilient, hydrophobic protective barrier that protects skin from moisture and irritants, such as urine and faeces, and prevents trauma and irritation (Waller and Cole, 2023). Its tacky consistency ensures adherence to moist and dry skin and on the periwound. The ointment should be evenly applied across the treatment area without rubbing it in, with more ointment needed for particularly wet or sore areas of skin.
Benefits of Medi Derma-PRO
The Total Barrier Protection strategy intends to support users in selecting the right product for the right level of skin damage, reducing the use of expensive products when they are not clinically indicated [See Figure 3].
Clinical and Patient Benefits
Various sources of evidence support Medi Derma-PRO‘s efficacy and patient benefits [See Box 1]. For example, Medi Derma-PRO has been shown to effectively reduce pain and improve skin integrity in end-of-life (EOL) patients at increased risk of MASD (Mahan and Cole, 2022). A recent case study has also shown that Medi Derma-PRO can be used to treat IAD in darker skin tones, where erythema of the skin may appear paler, darker, purple, dark red or yellow (Waller and Cole, 2023) [Figure 4].
