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Korean J Child Health Nurs. 1999 Oct;5(3):241-249. English. Original Article.
Song JH , Kim ST .
National Medical Center College of Nursing.
P & RS / R&CD Department, Proctoer & Gamble Far East, Inc. Japan Headquarters / Kobe Research Center.

Diaper dermatitis, or commonly called "diaper rash", is among the most prevalent cutaneous disorders of infancy and early childhood and important issue in nursing. The term itself is not diagnostic since it encompasses a variety of acute inflammatory reactions which are best regarded as a family of disorders arising from a combination of factors specifically attributable to the use of diapers. Intensive study of the rash process has shown that skin wetness and fecal enzyme activity are damaging to skin and lead to the development of diaper rash. This suggests that it is important to keep urine away from babies' skin, so that the skin remains as dry as possible and maintains its barrier function abilities. Controlling the urine will also minimize the mixing of urine and feces within the diaper, which helps prevent the increased activity of enzymes that attack the skin and cause irritation. Therefore, a diaper that keeps the skin drier and limits the mixing of urine and feces will help prevent the conditions that lead to diaper rash. Since their introduction about 35 years ago, disposable baby diapers have undergone many design and performance changes. In particular, the performance of diapers was advanced by the introduction of absorbent gel materials(AGMs) to provide advantages in skin care, dryness, and leakage protection. Especially, important was the introduction of AGM which increased the absorbent capacity of the diaper several fold and yielded marked reductions in the degree of skin hydration occurring under the diaper. Studies show not only drier skin but more stable skin pH and less dermatitis with AGM diapers than with home-laundered cloth diapers or single-use diapers without AGM. Minimizing diaper area skin wetness is important for managing and preventing diaper rash. To minimize wetness, parents should use super absorbent diapers, change them frequently, and gently clean the perineal area with each diaper change. In addition to the skin care benefits, disposable diapers are also better than cloth diapers in minimizing the risk of diarrhea outbreaks among infants and toddlers in day-care environments by reducing fecal contamination and minimizing the potential for transmission of gastro-intestinal tract disease in day-care settings. Furthermore, disposable diapers in the hospital provide nursing, health care, and other advantages over cloth diapers: convenience for nurses and parents, and better containment than cloth with less handling, decreasing the chance of spreading infections. These benefits extend from the care of infants in hospitals to children at home or in day care centers.

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