Assessing the Potential of Various Skin Protectant Products to Interfere with Brief Absorption

Best practice care for prevention and treatment of Incontinence Associated Dermatitis (IAD) includes use of a moisture barrier cream, ointment, or film. However, it has been suggested that some barrier products, particularly those that are petrolatum-based, may interfere with brief absorption. The objective of the study was to test the hypothesis that a unique polymer-based barrier cream has less potential to interfere with absorption of adult briefs than typical moisture barrier formulations. A modified in vitro fluid rate absorption test was used to compare the effect of seven skin protectants on the rate of fluid absorption by disposable incontinence briefs. The skin protectants utilized either dimethicone, petrolatum, zinc oxide, or a combination of petrolatum/zinc oxide as active ingredients. The results of this study confirm earlier reports using in vivo models that some skin protectants have the potential to interfere with absorbent brief function. 3M Cavilon Durable Cream had a lower potential for interfering with brief absorption function compared to Aloe Vesta Protective Ointment, Calmoseptine Ointment, Remedy Calazime Skin Protectant Paste and Secura Protective Ointment. There seems to be no clear pattern in discerning between products based on active ingredients. This leads one to conclude that the inactive ingredients probably play a significant role in interfering with absorbent brief function. Health care professionals should take brief compatibility into account when selecting moisture barrier products for the prevention or treatment of IAD. Background In 2002, Hart provided the first published evidence that oil-based skin protectants have the potential to interfere with absorbent brief function. In that study, a commonly used dimethicone moisture barrier (Cavilon Durable Barrier Cream) transferred significantly less (p<0.001) from the skin to absorbent briefs than either a petrolatum based ointment or a zinc oxide/castor oil protectant. Approximately 37% of the dimethicone cream transferred compared to 63% for both the petrolatum ointment and the zinc oxide/castor oil protectant. It was further demonstrated that the transfer of the dimethicone protectant cream did not have any effect on brief absorbency, as the briefs absorbed 96% of synthetic urine placed between the skin and the briefs, which was identical to the untreated control brief. In contrast, the absorbency of the briefs placed over the petrolatum ointment and zinc oxide/castor oil treated sites only absorbed 66% and 67% of the synthetic urine, respectively. In 2005, Zehrer et al. provided additional evidence that petrolatum-based moisture barriers have the potential to interfere with absorbent brief function. In that study, Cavilon No Sting Barrier Film (3M Health Care) was shown to not transfer from the skin nor interfere with brief absorptive function. However, from 59% to 69% of three commonly used petrolatum-based ointments did transfer from the skin to the brief, which decreased brief absorbency by 54% to 90% compared to untreated skin.