Barrier creams for those with incontinence ?

Catkins407

I have a young teenager who is fully doubly incontinent . I have been having trouble for the last year with skin staph infections. I have tried every wash and cream I could find and while I find hibiscrub a good wash for him I am still having difficulty finding a good barrier cream. I have doubled up his incontinence wear too in the hope this will help but would love any suggestions anyone may have for barrier creams they found that worked. Sudo was great for a while Vaseline and bepanthen but not any longer. Any names ? Over the counter or prescription would be appreciated .

Busybee4

Sorry I don't have an answer but if anyone does it would be great. My daughter is incontinent at night mostly only sometimes during the day, her bottom is always spotty, I keep changing creams they work for a while then I change am back to sudocream again and this is slowly working for now but will prob have to change again, it's like her skin becomes immune to it then I change and that works for a while then change again

Hybernian Angel

Hello, I'm a Nurse Manager caring for the elderly. Hibiscrub is extreamly harsh on skin, so I'd tend to avoid it. In my experience - although there are no clinical trials to support this - I'd use warm water with a small amount of Johnsons baby shampoo. Emmoliate with a thin layer of emulsifying ointment afterwords. If the skin is actually broken, or 'scalded', whip up an egg white ( keep it in the fridge for a day or so). Apply a thin layer to freshly washed skin and dry with a ( warm air flow only) hairdryer ( did this in Paeds years ago!). Alternatively - when the weather is getting better - exposing the skin is great for healing also. Wouldn't double up on pads - more expensive and really doesn't do anything. They're created to absorb a certain amount of fluid. If the one's you're using aren't doing the job - try fora stronger brand. Sometimes you can get a sales rep to advise....well worth a try. Best of luck.:)

Catkins407

Hi thanks for the replies. Some good ideas and good to know my son is not the only spotty one out there. The hibiscrub is diluted and is on advice from my sons paediatrician and gp . There is no scalded or broken skin just lots of spots. I will give the shampoo a try and always use an emulsifying ointment as a matter of course.

Hybernian Angel

Hummmn....I know after 27 years at this job I'd never use it as it's usually advised only to treat for MRSA etc. But if you're happy with it and it hasn't given you any problems - go ahead.:D Don't suppose the docs have outruled fungal infection with the sdpots ?. If so Canestan cream is really good. Just an idea.

Catkins407

They have ruled out fungal infections. I have tried canestan too. Seems like I have tried them all. I am happy to try the shampoo idea for a while because I do think your nursing experience is probably more relevant here. Nothing docs have said works.

Hybernian Angel

The idea of the shampoo is that it's not acidic or perfumed. Urine etc burns the skin and once dermatitis sets in you then need to not just protect ther skin - but heal it first. That's where the egg white comes in. Also don't forget exposure - gives the skin time to' breathe'. Best of luck.;)

fergal.b

A little bit off topic but my son's peg site has been leaking for the past few years leaving a very sore rash around it, I have also used all sorts of creams and powders with no luck would the egg white be ok to use on it as I'm willing to try anything at this stage
Thanks.







.

Hybernian Angel

That leaking around PEG sites has to be one of the most annoying and pervasive problems with PEG feeding. It's usually from the hydrochloric acid/feed leak. Dressings aren't advised - but personally speaking I don't really know any definitive way of stopping it. As long as it's not actually breaking down Fergal, it may need no treatment. You could try the egg white - it's a very, very old trick - not a researched 'cure'. It's just got to be cleaned off carefully with warm water each day. Try keep the area dry. Let me know how you get on. Is it a Mic Key button or Gastrostomy tube ?. Would never use powders as they tend to clog and cake when wet.....but then I'm totally anti powder use anyway.

fergal.b

We have gone through all the Mic key up to size 16 but it still leaked so now he has a Gastrostomy tube,it is a bit better leak wise as the feed is not coming out but pure stomach acid is "out of the frying pan and into the fire" The site never get's a chance to dry out as it leaks 24/7 he is on a feed for 20 hours a day and the stomach thinks it's getting food so keeps making acid so maybe the egg white will also just wash off I'll give it a go and see what happens.
Thanks for your help.






.

Hybernian Angel

I've researched the issue on my college website - but this info looks a little old to me. Not sure I'd go with Ranitidine and or Omeprazole unless indicated for by other reasons also. They do affect natural digestion to a certain extent. Still have a read. I do actually think the Duoderm might be a good idea also.;)

Gastric secretions leaking around the gastrostomy can result in skin excoriation. There are two methods of minimising irritation to the skin:

Use of a barrier ointment (better than cream)
Recommended products include Calmoseptine™ ointment, Ilex™ barrier ointment, or a zinc ointment.
If the site is affected by thrush, do NOT use a zinc based product as this may worsen the infection. Suitable alternatives include Orabase™ or Coloplast™ paste.
Medications to halt gastric acid production.
Ranitidine and/or Omeprazole.
These should only be prescribed by the treating unit.
Red, irritated, swollen, oozing skin surrounding a gastrostomy can be treated with:

A foam dressing, gauze or Sofwick to absorb excess ooze
Topical Magnesium + aluminium hydroxide preparations (eg Mylanta)
Hydrocolloid powder to aid in stopping bleeding and absorb excess moisture
A thin hydrocolloid dressing (eg Duoderm wafer) to protect and aid in healing of excoriated skin

Extrasupervery

Secura/triple care cream is the way to go!