Clinical and economic evidence supporting a transparent barrier film dressing in incontinence-associated dermatitis and peri-wound skin protection

Objective: To summarise the clinical and economic literature relating to the effect of Cavilon No Sting Barrier Film on the incidence of incontinence-associated dermatitis, which is a risk factor for pressure ulceration and exudate-related pen-wound skin damage. Method: A systematic literature search was performed using available computerised databases for publications on Cavilon barrier film and other relevant terms. Six clinical studies were identified providing data on 1,563 patients treated with the barrier film or a comparator. The publications comprised prospective studies, randomised and non-randomised studies, multicentre trials, single-centre reports and a volunteer study. Due to the nature of the comparators, five studies were open-label. Differences in methodology and outcomes made a qualitative review the most appropriate analysis. Results: The barrier film was at least as effective as petroleum ointments and more effective than zinc oxide formulations in preventing incontinence-associated dermatitis. The barrier film was also effective in pen-wound skin protection, although its clinical efficacy was not significantly different to that of petroleum ointments and zinc oxide formulations. Nevertheless, the barrier film was more cost-effective than either petroleum ointments or zinc oxide formulations in managing incontinence-associated dermatitis and pen-wound skin protection, largely due to savings in nursing time. Conclusion: The barrier film is at least as clinically effective and potentially more cost-effective in incontinence-associated dermatitis prophylaxis and pen-wound skin protection than petroleum ointments or zinc oxide formulations, releasing health care resources for alternative use. Further studies are required to quantify the relative efficacy and cost-effectiveness of the barrier film and other barrier formulations in different clinical settings and enhance the quality of the evidence base.