NCT05699122

Brief Summary

Incontinence-associated dermatitis (IAD) is defined as skin inflammation resulting from prolonged exposure to feces and/or urine, found in individuals with urinary incontinence, fecal incontinence, or both. Currently, preventive and treatment measures with strong clinical evidence include gentle hygiene and application of barrier products. Justification: Low-Level Laser Therapy (LLLT) is used in the tissue repair process, due to its analgesic, anti-inflammatory and biomodulator effects, with improvement in the treatment of pressure injuries. In this way, would the use of LLLT bring better results associated with topical treatment for the management of IAD?

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
16

participants targeted

Target at below P25 for not_applicable

Timeline
Completed

Started Feb 2023

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

January 2, 2023

Completed
24 days until next milestone

First Posted

Study publicly available on registry

January 26, 2023

Completed
6 days until next milestone

Study Start

First participant enrolled

February 1, 2023

Completed
5 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 30, 2023

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 30, 2023

Completed
Last Updated

September 13, 2023

Status Verified

September 1, 2023

Enrollment Period

5 months

First QC Date

January 2, 2023

Last Update Submit

September 11, 2023

Conditions

Keywords

ElderlyUrinary incontinence.Fecal incontinence.Diaper dermatitis.Low intensity light therapy.

Outcome Measures

Primary Outcomes (2)

  • Efficacy in the treatment of incontinence-associated dermatitis

    Three specialist judges, stoma therapist nurses with more than five years of experience in stoma therapy, will evaluate the photographic records of the first and last day and will evaluate: the percentage of area affected by DAI, the percentage of area affected by erythema, the percentage of area affected by erosion, percentage of area affected by denudation/ulceration, percentage of area affected by papules/satellite lesions, percentage of area affected by maceration. The evaluators will not know if the photo is from the first or the last day of treatment, they will not know the proposed treatment and they will not know about the evaluation of the other evaluator.With the results of the specialists' evaluations of the first and last day of follow-up, it will be verified whether or not there was an improvement in the characteristics of the IAD, verifying the effectiveness of the proposed treatment.

    4 days

  • Pain assessment in the treatment of incontinence-associated dermatitis

    Pain assessment can be performed with the Numeric Visual Scale with scores from 0 to 10 for conscious participants who will be able to report their pain score. In elderly people with cognitive impairment, periods of confusion and understanding, the Pain Assessment in Advanced Dementia (PAINAD) scale will be used, which has pain intensity from 0 to 10. Pain assessment will be performed on the first and last day of follow-up, during intimate hygiene, which is the right time to measure pain, by the principal investigator.

    4 days

Study Arms (4)

The Control Group - Persistent erythema with intact epidermis

ACTIVE COMPARATOR

The Control Group - Persistent erythema with intact epidermis

Other: Gentle intimate hygiene and skin protective barrier application - Persistent erythema with intact epidermis

The Experimental Group - Persistent erythema with intact epidermis

EXPERIMENTAL

The Experimental Group - Persistent erythema with intact epidermis

Other: Low Level Laser Therapy - Persistent erythema with intact epidermis

The Control Group - Erythema with signs of epidermis loss

ACTIVE COMPARATOR

The Control Group - Erythema with signs of epidermis loss

Other: Gentle intimate hygiene and skin protective barrier application - Erythema with signs of epidermis loss

The Experimental Group - Erythema with signs of epidermis loss

EXPERIMENTAL

The Experimental Group - Erythema with signs of epidermis loss

Other: Low Level Laser Therapy - Erythema with signs of epidermis loss

Interventions

Follow-up will be for 4 days, current treatment will be carried out with: Perform intimate hygiene with warm water (to remove excess feces and urine), apply skin cleanser without rinsing to finish cleaning, apply a thin layer of Dexpanthenol (with each diaper change), apply polymeric spray solution once a day.

The Control Group - Persistent erythema with intact epidermis

Follow-up will be for 4 days, current treatment will be carried out with: Perform intimate hygiene with warm water (to remove excess feces and urine), applying a leave-in skin cleanser to finish cleaning, applying powdered hydrocolloid powder and removing excess. Afterwards, apply a polymeric spray solution.

The Control Group - Erythema with signs of epidermis loss

Follow-up will be for 4 days, current treatment will be carried out with: Perform intimate hygiene with warm water (to remove excess feces and urine), apply skin cleanser without rinsing to finish cleaning, apply a thin layer of Dexpanthenol (with each diaper change), apply polymeric spray solution once a day. It will be associated with the application of Low Intensity Laser Therapy. The entire area affected by DAI will be irradiated with LBI at 1 Joule (J) of energy and with a wavelength of 660nm and 1J with a wavelength of 808nm, which will be applied simultaneously, with a radiance of 20J/cm2 per point, the distance between the stitches will be 1cm long and the application of LLLT will be performed every 24 hours.

The Experimental Group - Persistent erythema with intact epidermis

Follow-up will be for 4 days, current treatment will be carried out with: Perform intimate hygiene with warm water (to remove excess feces and urine), applying a leave-in skin cleanser to finish cleaning, applying powdered hydrocolloid powder and removing excess. Afterwards, apply a polymeric spray solution. It will be associated with the application of Low Intensity Laser Therapy. The entire area affected by DAI will be irradiated with LBI at 1 Joule (J) of energy and with a wavelength of 660nm and 1J with a wavelength of 808nm, which will be applied simultaneously, with a radiance of 20J/cm2 per point, the distance between the stitches will be 1cm long and the application of LLLT will be performed every 24 hours.

The Experimental Group - Erythema with signs of epidermis loss

Eligibility Criteria

Age60 Years - 100 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Elderly people who have Incontinence-Associated Dermatitis (persistent erythema with intact epidermis and erythema with signs of epidermal loss) admitted to the surgical medical clinic;
  • Elderly people who have Incontinence-Associated Dermatitis (persistent erythema with intact epidermis and erythema with signs of epidermal loss) admitted to the the semi intensive.

You may not qualify if:

  • Elderly with medical prescription for another proposed treatment for IAD that is not in the institutional protocol;
  • Elderly with change in behavior proposed by the nursing team during the study period;
  • Elderly in the final stage of life;
  • Elderly with some hemodynamic instability due to signs of progressive organ dysfunction and/or suspected deterioration of clinical conditions with need for transfer to intensive care during the study period;
  • Elderly newly diagnosed with cancer in need of transfer to oncology to start treatment during the study period; Elderly who have been newly diagnosed with COVID-19 and need to be transferred to the cohort area during the study period.
  • Elderly people using product for the treatment of dermatitis associated with incontinence incompatible with the application of low-intensity laser therapy.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Hospital Israelita Albert Einstein

São Paulo, Brazil

Location

MeSH Terms

Conditions

DermatitisUrinary IncontinenceFecal IncontinenceDiaper Rash

Condition Hierarchy (Ancestors)

Skin DiseasesSkin and Connective Tissue DiseasesUrination DisordersUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital DiseasesLower Urinary Tract SymptomsUrological ManifestationsSigns and SymptomsPathological Conditions, Signs and SymptomsRectal DiseasesIntestinal DiseasesGastrointestinal DiseasesDigestive System DiseasesDermatitis, IrritantDermatitis, ContactSkin Diseases, Eczematous

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Masking Details
Through the results of the verbal and numerical scale or PANAID obtained on the first and last day of follow-up, it will be verified whether or not there was an improvement in pain during intimate hygiene in the area affected by IAD. With the results of the specialists' evaluations of the first and last day of follow-up, it will be verified whether or not there was an improvement in the characteristics of the IAD, verifying the effectiveness of the proposed treatment.
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigador

Study Record Dates

First Submitted

January 2, 2023

First Posted

January 26, 2023

Study Start

February 1, 2023

Primary Completion

June 30, 2023

Study Completion

June 30, 2023

Last Updated

September 13, 2023

Record last verified: 2023-09

Data Sharing

IPD Sharing
Will not share

Locations