Do Intra-anal Bowel Management Devices Reduce Incontinence-Associated Dermatitis and/or Pressure Injuries?

Area of Science:

• Medical Devices
• Gastroenterology
• Dermatology

Background:

• Fecal incontinence is a significant issue in acute care settings, leading to complications like incontinence-associated dermatitis (IAD) and pressure injuries (PI).
• Effective management strategies are crucial to prevent skin breakdown and improve patient outcomes.

Purpose of the Study:

• To evaluate the effectiveness of intra-anal bowel management systems (IBMS) in reducing IAD and PI in adult patients.
• To provide evidence-based recommendations for the use of IBMS in clinical practice.

Main Methods:

• A systematic literature search identified 133 articles on IBMS, IAD, and PI.
• Six studies met the inclusion criteria and were reviewed for evidence strength.
• Evidence was rated using established methodologies (Essential Evidence Plus, Oxford Centre for Evidence-based Medicine).

Main Results:

• Five of six studies reported that IBMS significantly reduced IAD and/or PI.
• One randomized controlled trial found no significant difference compared to usual care.
• The safety of IBMS was confirmed in two studies, with moderate evidence strength (2 Level A, 3 Level B, 1 Level C).

Conclusions:

• Intra-anal bowel management systems are a viable option for managing fecal incontinence.
• These systems demonstrate effectiveness in reducing incontinence-associated dermatitis and pressure injuries.
• The use of intra-anal bowel catheters and rectal trumpets is supported by current evidence.