Incontinence-associated dermatitis: a consensus.

Incontinence-associated dermatitis (IAD) is an inflammation of the skin that occurs when urine or stool comes into contact with perineal or perigenital skin. Little research has focused on IAD, resulting in significant gaps in our understanding of its epidemiology, natural history, etiology, and pathophysiology. A growing number of studies have examined clinical and economic outcomes associated with prevention strategies, but less research exists concerning the efficacy of various treatments.

Preventing and managing surgical wound dehiscence.

Most surgical wounds heal uneventfully--the dehisced surgical incision is definitely the exception to the rule. However, management of a dehisced incision is a fairly common home care challenge that must be understood. This month's column answers the questions: Why do some incisions dehisce, and what, if anything, can be done to prevent dehiscence? Are there early warning signs to look for? How should a dehisced wound be managed?

Promoting continence: simple strategies with major impact.

Urinary incontinence is a common problem, especially among women, yet it remains underreported and undertreated. This is partly due to patients' beliefs that little can be done and partly due to healthcare professionals' perception that treatment is limited to surgery, advanced behavioral strategies requiring specialized equipment, or containment devices. Nurses are in a strategic position to reduce the incidence of incontinence by teaching bladder health strategies (ie, fluid management, appropriate voiding intervals, constipation prevention, weight control, smoking cessation, and pelvic muscle exercises), actively assessing patients for incontinence, and initiating appropriate referrals and primary interventions.

When fiber is not enough: current thinking on constipation management.

Constipation is a common disorder and many patients fail to respond to the simple constipation remedies of increased fiber and fluid intake. When secondary to other conditions, medications, or disease processes, the focus of constipation management is correction of causative factors. However, primary constipation - ie, constipation with no identifiable causative factor - is very common.