Introduction to Abenas Abri-San Fecal Incontinence Pad. Very soft and super absorbent!
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Skin needs to breathe. Abena’s Air Plus products allow it to do so whilst at the same
time minimising any risks of leakage and thereby making the products from Abena unique. You can compare the Air Plus back-sheet foil to Goretex – a material used for e.g. waterproof clothing.Half a decade ago you could still find baby diapers with traditional PE backsheet foil. Those days are gone, as today all baby diapers are produced with a breathable-textile-like back sheet foil. In time, the same thing will happen with all incontinence products.
However, Abena already has a full and complete range of Air Plus products, that all allow the skin to breathe.|
The Abena Air Plus backsheet foil is unique. Because it is a laminate which consists of two different layers, a breathable polyethylene (PE) foil, which is made breathable by adding chalk in the production process, and a polypropylene (PP) nonwoven (NW).
The fact that the backsheet foil is a laminate consisting of two different materials (PE and PP) provides a number of special advantages:
It makes our Air Plus back sheet foil stronger than the traditional PE foil and it makes it completely noiseless
compared to traditional PE foil The NW layer makes the back-sheet foil feel “textile-like”
There are various levels of breathability with materials and whilst some may seem “textile-like” they do not offer the breathability of Abena Air Plus. You will therefore find products on the market,which feel soft, like an Air Plus product, but they are not breathable. Products with such a backsheet foil come at a lower price than the breathable products because the material will be less specialized and therefore a much lower cost. The level of breathability of the laminate can be measured and is measured in Lyssy or Mocon.
After years of testing, we at Abena have found, that an optimum level of breath-ability should be on approximately Lyssy 1500 (approx. 3000 Mocon), because that is where you find the ideal balance between providing optimum conditions for the skin, all while securing that any fluids and odor does not penetrate the backsheet foil.
Quality makes savings
Price is a crucial factor when considering the move to a full conversion to Air Plus products. However, in evaluating the total costs with Continence Management, Abena Air Plus products save money. The Air Plus products help to keep skin in a better condition, thereby saving money for the treatment of skin problems and they contribute to a higher level of well being and thus quality of life, making everyday life so much easier – both for the users and the care staff.
After using pads with breathable foil for 15 months, patients on two different wards ac
commodating adult patients with severe brain damage, had fewer skin problems ac-
cording to clinical nurse Lisbet Fog and her colleagues.
»It is disgraceful – there must be another way!« That thought became the starting
point for Lisbet Fogs diploma study on breathable foil. Lisbet Fog works as a Clini-
cal developmental nurse and Continence advisor at the regional hospital Hammel
Neurocenter. Breathable foil does not seem of much on its own, but in the hands of a dedicated Lisbet Fog, the breathable foil has made a hugedifference for the patients with heavy brain damage, among whom she works: these are
patients who have experienced losing basic-skills from one second to the next, and Lis-bet was sure they felt it to be very undigni-fied to be wrapped into large all-in-onebriefs, even though they could not object to it. Further-more, a number of those patients suffered skin problems in the intimate areas: for all these reasons it was decided to inves-tigate the effects of pads with breathable foil.
Focus on the pad
For years, Lisbet Fog has been working with neurological patients, who face a number of different and complex problems. These days, the main focus is on new treatment, revolutionary scan results or groundbreaking rehab, and then it can be difficult to turn fo-cus to something as simple as a pad. But Lisbet Fogs engagement motivated her col leagues, and supported by management and dedicated colleagues she managed to introduce a system for testing the pads with breathable foil on two wards of the hospital, which accommodates 14 adult patients.
A question of dignity
In the process Lisbet Fog and her col- leagues focused on the size of the pad, which stimulated discussions about the pa- tient’s dignity. Lisbet convinced her col-leagues of the importance of paying atten-tion to the type of pad to offer, making sure it has the right size and – most important –always choosing according to the needs of the patient. After 15 months of testing Lisbet Fog and her colleagues concluded that the pads with breathable foil had made a noticeable difference for the patients at the two wards.
Abena’s professional articles –part of the Abena educational concept
Summary of diploma study
By Lisbet Fog
Clinical developmental nurse SD. Continence advisor,Regional hospital Hammel Neurocenter
This article describes knowledge and clini-cal experience regarding the use of brea-
incontinence products used on two sections of a rehabilitation centre for pa-
thable tients with brain injuries.
When people in a period of their lives are unable to take care of themselves, it is important to be able to offer the best care and treatment based
on the newest knowledge available.
This knowledge is the sum of experiences from the staff, patient’s wishes and experiences, the context and research results.It is im-portant that this sum is put down in writing.
What is incontinence related dermatitis?
Incontinence related dermatitis is a condi-tion that arises in connection with the use
of incontinence products. It is a joint term for all acute inflammatory responses in the
intimate areas of the body.
The causes are many and the connection complex (1).
Employees within the health sector meet people on a daily basis that use briefs or
pads because of incontinence. Inconti-nence related dermatitis is very uncomfor-
table for the patient and can cause stinging,soreness and maceration. This leads to an
increased risk of infections and fever.
Causes and incidents of incontinence re-lated dermatitis
Incontinence related dermatitis is caused by four central factors that separately affect the risk of the development
(1) The product’s contact with the skin induces a mechanical irritation. If the
moisture is kept inside, the risk of mace-rating the skin occurs.
2) Urine on the skin exposes it to moisture and there is a risk of maceration. This
increases the risk of a rise of the pH-value. Ammonia reduces the free
fatty acids and damages on the skin’s permeability.
3) Faeces on the skin causes a mechanical
irritation. There are fat- and protein dissolving enzymes in faeces. Diarrhoea
has a higher pH-Value and larger amounts of enzymes than normal
faeces. A pH-value of more than 6.5 means, that the enzyme effect increa-
ses the risk of skin damage.
4) Frequent use of water and soap irritates and degreases the skin and damages the stratum conium. Bacteria survive,
and multiply on skin with wounds and cracks, where it is difficult to clean.
Wash with water removes water-soluble agents. Micro organisms are not water-
soluble. The washing effect is therefore limited (1).
If all factors are present, the risk of incon-tinence related dermatitis is intensified.
Together the permeability of the skin chan-ges and reduces the defence ability against
toxic agents such as ammonia, soap, gall-salts etc. The skin reacts with inflammation
= incontinence related dermatitis (1). It is assumed that this will produce an incre-ased risk of infection of the urinary tract.
Studies show that up to 30 % of the care demanding elderly people in institutions can have problems with incontinence related
dermatitis. (1, 2) The risk of infections is assumed to be much higher in the hospital
environment, where bacteria flora is shared with a lot of people compared to the home
environment. Prevention of incontinence related dermatitis Prevention of incontinence related dermati-
tis can assist in reducing the risk of urinary tract infection e.g. if the brief is changed
after each void/faeces and product type and size are chosen according to the ne-
eds of the patients. Hygiene in the intimate areas must, according to ”Dansk Standard”
(Danish Standard agency) be carried out at each change of a wet brief with i.e. wa-
shing crème or soap with a pHvalue below 6 (3) The skin must be dabbed dry. Urine
and faeces must, as far as possible, avoid skin contact. Faeces can be removed with
water and soap/washing crème/oil. These products are fat dissolving. By continuous
skin irritation it can be necessary to treat an asymptomatic infection of the urina-
ry tract, as bacteria in the urine leads to formation of ammonia before the urine
gets into contact with the skin and the incontinence product (4).
it is also important to offer the patients regular visits to the toilet. A visit to the
toilet must not be replaced by an inconti-nence product (4).
Type of skin must be taken into account when skincare is con-sidered. Dry skin must be smeared with a
fat crème containing 50-70 % fat. Greasy skin and normal skin can be smeared with
skincare products that are more watery (4). If there is redness on the skin a barrier
cream can be used.Knowledge and clinical experiencePatients from two sections of a rehabili-
tation centre caring for people with brain injuries are often suffering with urinary
and bowel incontinence when they are ad-mitted. The reason for this is related to lack
of consciousness, reduced mobility, cogni-tive dysfunctions and the lack of ability to
ask for help. The patients often have a strong abnormal sweat tendency in the beginning of the ad-
mission. They have had great loss of weightin the acute progress and they are in a
bad condition. There is a risk of developing incontinence related dermatitis, and the-
reby there is an increased risk of infection.A consequence of incontinence related der-
matitis can be fever, and research shows that repeated fever episodes can set
people with brain injuries back in their reha-bilitation process and reduce the prognosis
(5). Economically it can increase the costs for the admitted patient due to an ad-
ded number of admission days becauseof complications and treatment of these (5).
Therefore it is important to prevent complications. In spite of focus on the hygiene
by lower dress (intimate care) and changing of the brief, some patients still had problems in the
intimate areas of the body in form of redness and/or fungus that was treated after cause. During my education as a con-
tinence advisor in 2005, I was introducedIncontinence related dermatitis prophylaxis
Abena’s professional articles –part of the Abena educational concept2
to ”breathable incontinence products”. This led to a test of these new incontinence pro-
ducts. Supported by the management and engaged colleagues, these new products
were tried in two sections. In all, these two sections have 14 adult patients admitted to
intensive neuro rehabilitation. Test of breathable incontinence products
The aim of this test was to prevent or re- duce the patient’s incontinence related der-
matitis. Furthermore we have focussed on making sure the size of the product is cho-
sen according to the needs the patients. Today incontinence products are developed
to absorb the most in the smallest possiblesize (6). In the section we have not previous-
ly focussed on the size of the incontinence product, but often an all-in-one product with
plastic backsheet foil was chosen. Dignity from the patients point of view was
discussed. Dignity is important in regards to what the focus of the care staff is. What is
right and wrong and good and bad nursing (7). Therefore it is relevant to pay attention
to which type of incontinence product is offered to the patients, correct use of the
product with emphasis on the patient’s needs and wishes, so the dignity is in the
centre of focus. An assessment chart was made, where it was registered when the product was
changed, the product size used and how much the product was used. After a couple
of days it would show which product size the patient needed at different times of the day.
Two years have passed since the breath- able products were taken into use and the
products were modified to fit the patients’ needs. It is the staff’s experience that
patients have fewer skin problems. Another experience is that the patient must be offe-
red a slightly larger incontinence product in the beginning, because it is not acceptable
for the patient’s clothes to get wet. The as-sessment chart is a useful tool to find the
correct product size. The products have been ordered in all sizes, so the patients can get the size they
need. The chart reflects individual nursing focused on patient’s need. Some patients
still need large products, but the product is breathable and has been applied with
thoughtfulness. This has been documented in the patient’s care plan. Hereby the health authorities’ demands on the way the nur-ses must carry out their jobs with care and conscientious are met. This involves the fact that the nurse has to be able to argue for the use of and the need for nursing (8).If the National Board of Health directions
on professional nursing records must be met, documentation is a requisite (9).
Theoretical study on breathable incontinence products In connection with the preparation of the
final project for the Professional Diploma in 2007, I chose to investigate to which
extent there is evidence for the fact that breathable incontinence products are effi-
cient regarding the development of incon-tinence related dermatitis (10).
Evidence was defined from Rycroft-Malone et al ́s suggestion to a wider evi-
dence foundation and a frame of referencefor the assignment was used (11). Rycroft-
Malone et al established that nurses useda great number of knowledge sources in
practice and collaboration with the patient. The four types of evidence, which are used
in practice, are:Research results Clinical experience Patients/clients/care staff’s experiences Knowledge from local context and the environment The problem statement is addressed or clarified from four sources of evidence, as
described in Rycroft-Malone et al ́s model.
The research indicates that breathable in-continence products have a positive effect in the reduction of incontinence related
dermatitis. Staff from two sections has ex- perienced the fact that patients have less
skin problems, when they use breathable incontinence products. The patients’ prefe-
rences lack. Nothing has been found in the local context or the environment. In spite of
the sparse evidence it has been the correct decision to introduce breathable inconti-
nence products. On focusing on incontinen-ce related dermatitis it was found several
factors are influential in its cause. Incontinence related dermatitis prophylaxis
Abena’s professional articles –part of the Abena educational concept 3 A positive result can be connected with
correct use of product. However the positive result may also be due to incre-
ased awareness concerning hygiene, skin assessment and therefore care.
The final conclusion of the project was:The clinical experiences from the two
sections show that the patients had fewer incidents of incontinence re-
lated dermatitis after the introduc-tion of breathable incontinence pro-
ducts. A metha analysis concludes that there is no evidence from good
randomised studies that supports or refuses the use and the type of incon-
tinence product in prevention of incontinence related dermatitis (12).
In a clinical, randomised, controlled attempt, the result indicates that
breathable incontinence products can have an effect on reducing
the development of incontinence related dermatitis, so less incontinen-
ce related dermatitis is seen (13). A cohort study shows a significant
im provement of incontinence rela- ted dermatitis after trying a certain
breathable incontinence product (2).The patient perspective lacks.
The most valid evidence must be ascri-bed to the care staff’s clinical practice
from the two sections involved have used breathable incontinence products
during a period of 15 months and have found the patients to suffer less from
incontinence related dermatitis.
KCK Medical and Abena USA
Abena A/S . Egelund . DK-6200 Aabenraa . Denmark
Tel.: +45 74 31 17 00 . Fax: +45 74 31 18 09 . http://www.abena.com
Abena’s professional articles –part of the Abena educational concept
Abena and the Environment
The Nordic governments want to be leaders in protecting our environment.
The welfare of the environment and even more superior product quality are core objectives in all Abena product development.
Nordic Eco-Label products are among the most eco-friendly available today: the benchmark levels for environmental requirements are constantly increasing, and Abena Group are at the cutting edge of market developments.
Abena’s new Premium incontinence products are the first to carry the Nordic Eco-label.
With respect for the environment The Nordic Eco-label
Climate – all wooden fibres must come from sustainable forestry
Raw Materials – all raw materials must comply with strict conditions in order to be approved
e.g. reducing CO2 pollution
Harmful chemicals – Chemicals such as perfume and lotions are not allowed
Hazardous effluents – all waste water must be“cleaned” i.e. contain less than 0,15 kg AOX/tpaper*
Waste – a maximum of 5% waste content is allowed
Packaging – instructions must be easily readable on the
Government requirements – all government requirements must be met
(*AOX=Absorbable Organic Halogens which is a measurement used in waste water
to indicate the overall level of halogens; fluorine, chlorine, bromine and iodine)
Abena Brands improve quality and performance in 2011.
The new line has a sleek new retail look and is more absorbent than ever.This line of incontinence products has unique features not found in any domestic product lines, a 4000 ml absorbency capacity (Large X-Plus), and unprecedented leakage control and is fully breathable providing a super comfortable product. The Abri-Form Premium is designed using the most advanced materials and engineered to create a new standard in adult absorbent products.
The New Premium line is available in for 2011. Abena brand products are distributed through authorized incontinence dealers throughout the globe.
Abri-Form Premium is a complete range of all-in-one briefs for moderate
to heavy incontinence. Designed to give optimum leakage
security and are particularly suitable for highly demanding situations.
The Abri-San range offers a complete range of anatomically shaped
pads for all degrees of incontinence.
Abri-Flex products can be worn just like normal
underwear, enhancing the users feeling
of freedom and dignity.
For information and availability contact us at 888-880-1967