LINKING ABSORBENT INCONTINENCE PRODUCT DESIGN TO SKIN BARRIER PROTECTION: AN OUTCOMES FRAMEWORK FOR INCONTINENCE-ASSOCIATED DERMATITIS PREVENTION
Author(s)
Olga Vechter, MSc1, Yana Arlouskaya, MSc1, Niuosha Sanaeifar, PhD2, Rüdiger Kesselmeier, PhD1, Pia Beer, MSc3, Janina Tiemann, PhD3, Agnieszka Segiet-Swiecicka, PhD, MD4, Daniel Rabczenko, PhD4, Robert Garcia, MSc5, Luca Ferrandi, BSc6, Hans Smola, MD1.
1PAUL HARTMANN AG, Heidenheim, Germany, 2Senior Manager Clinical Evidence & Research, PAUL HARTMANN AG, Heidenheim, Germany, 3Dermatest GmbH, Münster, Germany, 4Clean Data Labs, Warsaw, Poland, 5PGI Spain S.L., Tarragona, Spain, 6Fiberweb Terno d’Isola S.r.l.,, Bergamo, Italy.
1PAUL HARTMANN AG, Heidenheim, Germany, 2Senior Manager Clinical Evidence & Research, PAUL HARTMANN AG, Heidenheim, Germany, 3Dermatest GmbH, Münster, Germany, 4Clean Data Labs, Warsaw, Poland, 5PGI Spain S.L., Tarragona, Spain, 6Fiberweb Terno d’Isola S.r.l.,, Bergamo, Italy.
OBJECTIVES: Incontinence-associated dermatitis (IAD) is a common complication in individuals with incontinence and is associated with prolonged moisture exposure, changes in skin surface pH, friction, and disruption of the epidermal barrier. This work aimed to develop an outcomes-oriented framework linking absorbent incontinence product design features to skin barrier protection and future evaluation of IAD prevention.
METHODS: A published exploratory monocentric study of an optimized absorbent incontinence product design was used as the evidence source for developing the framework. Product performance outcomes included rewetting, fluid acquisition, and surface pH after repeated synthetic urine loading. In the human alkaline challenge model, 75 healthy volunteers were exposed for 6 hours to alkaline synthetic urine applied using both the optimized absorbent core and a cellulose pad control at separate test sites in an intraindividual comparison. Transepidermal water loss (TEWL) and erythema were assessed before and after exposure as barrier-function and skin-redness outcomes. The relevance of these barrier-related outcomes to future HEOR endpoints for IAD prevention was considered.
RESULTS: The optimized design demonstrated low rewetting after first and second fluid loading and maintained a skin-adapted acidic surface pH over repeated loading. In the alkaline challenge model, the optimized absorbent core was associated with a smaller TEWL increase than the cellulose control (mean: 3.43 versus 8.38 g/m²/h; p<0.001). Erythema increase was also lower with the optimized design than with the cellulose control (mean: 1.18 versus 2.56; p<0.001). These findings support a biologically plausible pathway linking reduced rewetting and maintenance of an acidic surface pH with epidermal barrier protection.
CONCLUSIONS: Absorbent incontinence product design features that reduce rewetting and maintain an acidic surface pH may support epidermal barrier protection under alkaline challenge conditions. Future HEOR studies should determine whether these barrier-related effects translate into a lower risk of IAD development, reduced nursing time, lower treatment costs, and decreased patient-centered burden.
METHODS: A published exploratory monocentric study of an optimized absorbent incontinence product design was used as the evidence source for developing the framework. Product performance outcomes included rewetting, fluid acquisition, and surface pH after repeated synthetic urine loading. In the human alkaline challenge model, 75 healthy volunteers were exposed for 6 hours to alkaline synthetic urine applied using both the optimized absorbent core and a cellulose pad control at separate test sites in an intraindividual comparison. Transepidermal water loss (TEWL) and erythema were assessed before and after exposure as barrier-function and skin-redness outcomes. The relevance of these barrier-related outcomes to future HEOR endpoints for IAD prevention was considered.
RESULTS: The optimized design demonstrated low rewetting after first and second fluid loading and maintained a skin-adapted acidic surface pH over repeated loading. In the alkaline challenge model, the optimized absorbent core was associated with a smaller TEWL increase than the cellulose control (mean: 3.43 versus 8.38 g/m²/h; p<0.001). Erythema increase was also lower with the optimized design than with the cellulose control (mean: 1.18 versus 2.56; p<0.001). These findings support a biologically plausible pathway linking reduced rewetting and maintenance of an acidic surface pH with epidermal barrier protection.
CONCLUSIONS: Absorbent incontinence product design features that reduce rewetting and maintain an acidic surface pH may support epidermal barrier protection under alkaline challenge conditions. Future HEOR studies should determine whether these barrier-related effects translate into a lower risk of IAD development, reduced nursing time, lower treatment costs, and decreased patient-centered burden.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
MT12
Topic
Clinical Outcomes, Medical Technologies
Disease
Geriatrics, No Additional Disease & Conditions/Specialized Treatment Areas