分析住宿式長照機構住民對磨性皮膚炎之相關因素

Analyzing Factors Related to Intertriginous Dermatitis in Residents of Residential Long-term Care Facilities

對磨性皮膚炎是皮膚皺褶處的刺激性接觸性皮膚炎，出現在各個照護場域之中，盛行率由2.4%到40%不等。住宿式長照機構的住民因為高齡、生活功能高度依賴、多重共病與多重用藥等特性，加上照護所使用的產品與輔具（如輪椅和床墊）對皮膚而言具有封閉性，是發生對磨性皮膚炎的高風險族群。而對磨性皮膚炎常合併真菌感染，導致個體不適，衝擊生活品質，同時影響照護品質。要有效預防對磨性皮膚炎，可從多方面執行照護措施，包括選用弱酸性皮膚清潔液和潤膚劑來執行皮膚照護，維持皮膚防禦功能；選擇純棉或具排汗功能的衣著，並保持皮膚皺褶處的清潔與乾爽，提升住民舒適度；教育照護團隊成員提升對磨性皮膚炎的認識與警覺，並適時轉介專業人員。預防對磨性皮膚炎的發生為皮膚照護的重要課題，可提升住宿式長照機構住民整體的照護品質。

Intertriginous dermatitis is an irritant contact dermatitis that occurs in skin folds and is found across various care settings, with a prevalence from 2.4% to 40% (Arnold-Long & Johnson, 2019; Everink et al., 2021; Gabriel et al., 2019; Kottner et al., 2020; Liao et al., 2001; Osmancevic et al., 2022; Valls-Matarin et al., 2017; Werth & Justice, 2019). Residents of residential long-term care facilities are at risk due to their old age, daily activity functions are dependent, multiple comorbidities, and polypharmacy. The occlusive nature of the care products and assistive such as wheelchairs and mattresses used can also contribute to the risk. Intertriginous dermatitis is often combined with fungal infections, causing discomfort and impacting the quality of life and care. Preventing intertriginous dermatitis can be implemented through various care practices. Using low pH skin cleansers and moisturizers to maintain the skin barrier function; selecting cotton or sweat-wicking clothing to keep skin folds dry, enhancing residents’ comfort; and educating care team members to increase knowledge and awareness of intertriginous dermatitis, along with timely referral to professionals. Preventing intertriginous dermatitis will become an important issue in skin care to improve the overall quality of care for residents.