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An Integrative Review of Clinical Characteristics of Infants With Diaper Dermatitis
Media S Esser1, Teresa S Johnson
1Children's Hospital of Wisconsin, Milwaukee (Ms Esser); and College of Nursing, University of Wisconsin-Milwaukee (Ms Esser and Dr Johnson).
Insights
Diaper dermatitis (DD) severity assessment needs more clinical characteristic (CC) data. Understanding CC impact on DD can improve infant skin condition outcomes and identify further risk factors.
Area of Science:
- Pediatrics
- Dermatology
- Neonatal Care
Background:
- Diaper dermatitis (DD) severity is typically assessed by erythema and skin breakdown.
- Existing literature often lacks comprehensive descriptions of clinical characteristics (CC) associated with DD.
Purpose of the Study:
- To review and analyze the descriptions of CC in infants with DD within published literature.
- To identify commonly reported CC and assess their correlation with DD severity.
Main Methods:
- Systematic literature search of PubMed and Web of Science.
- Keywords: diaper dermatitis, diaper rash, infant, neonate.
- Inclusion criteria: published post-1990, English, skin assessment data, infants < 2 years; excluded reviews/opinions.
Main Results:
- 27 relevant studies were identified from 454 initial results.
- Most frequently reported CC: feeding type, stool frequency, prior DD history, antibiotic use, delivery mode.
- Inconsistent reporting of CC and lack of correlation with diapered skin condition were noted.
Conclusions:
- Acknowledging the impact of CC on DD development can improve skin condition outcome variables.
- Integrating CC assessment with existing measures may enhance the rigor of DD severity descriptions.
- Future research should explore environmental factors and additional risk factors for DD.
Background:
Diaper dermatitis (DD) severity is demonstrated by the degree of erythema and skin breakdown. Many studies describe diaper dermatitis, but lack a full description of clinical characteristic (CC) involvement.
Purpose:
The purpose of this literature review is to explore the descriptions of CC of infants with DD provided within infant DD literature.
Search Strategy:
PubMed and Web of Science were searched using the keywords: diaper dermatitis, diaper rash, infant, and neonate. The inclusion criteria for this project are as follows: published after 1990, English language, include skin assessment or evaluation, and infant/children < two years of age. Review and opinion articles were excluded.
Results:
A total of 454 studies were retrieved, 27 remained after review for duplicates and relevance. The CC described most often were: type of feeds, stool frequency, history of DD, use of antibiotics, and delivery mode.
Synthesis Of Evidence:
The studies reported inconsistent CC and a lack of correlation between these characteristics and the condition of diapered skin. Many studies focused solely on the efficacy of interventions lacking description of possible relationships between DD and CC.
Implications For Practice:
Skin condition outcome variables can be improved with the acknowledgment of the impact CC have on the development of DD. The combination of assessment measures and CC may ultimately demonstrate more merit or rigor for describing DD severity and skin condition.
Implications For Research:
Future research should expand this exploration to include environmental or contributing factors to continue to identify additional risk factors for DD.
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