Effectiveness of Zinc Oxide Ointments Versus Non-Irritating Barrier Films in the Prevention of Incontinence-Associated Dermatitis

Objectives: To evaluate the effectiveness of zinc oxide (ZnO) ointments versus non-irritant barrier films (NIBFs) in the prevention of Incontinence-Associated Dermatitis (IAD). Specific objectives included analyzing the effects of treatment over time, establishing when IAD appears in each group, and determining the safety and cost-effectiveness of both treatments. Methodology: A multicenter prospective cohort study was carried out in 10 social health centers in Spain. The final sample included 164 older institutionalized patients with urinary and/or mixed incontinence, divided into two cohorts (79 with ZnO and 85 with NIBF). Follow-up lasted for six weeks. Validated scales were used for data collection, such as the Categorization of Moisture-Associated Skin Damage (MASD) of the GNEAUPP (National [Spain] group for the assessment of pressure ulcers and chronic wounds) and the Visual Erythema Scale (VES). Results: The overall incidence of IAD was 20.7% in the sample during follow-up. No statistically significant difference in effectiveness was found between ZnO (27.8% incidence of IAD) and NIBF (32.9% incidence of IAD) in preventing IAD (p=0.479). However, survival analysis suggested that the onset of IAD is delayed more in the NIBF group. No adverse events or side effects were reported attributable solely to the use of the products. When considering the total cost per process (including staff application time), ZnO ointment was €0.06 more expensive per patient per day than NIBFs. Conclusions: Although both products have similar efficacy and safety, NIBFs delay the onset of IAD more than ZnO. In addition, despite a higher unit price, NIBFs are more cost-effective per procedure because of savings in nursing time during application and removal.