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The etiology of a DR is multifocal and the rash is not a single entity, but a reaction of the skin to several factors, both local and systemic (Liptak, 2001). There are several causative theories, ranging from food allergies to damage of the stratum corneum or the skin's top layer such as maceration, friction, and chapping (Liptak, 2001; Spraker, 2000). Wetness, dry skin, cleansing agents such as soap, elevated pH levels, fecal enzymes, fecal incontinence, and diarrhea due to infection or antibiotic use will alter skin integrity making the skin more susceptible to diaper dermatitis (Liptak, 2001; Spraker, 2000). Urinary incontinence may be associated with pediatric anomalies, neurological disorders, genetic syndromes, and trauma. Conditions associated with fecal incontinence may include: an ostomy takedown, anorectal malformations, perineal fistula, spina bifida, Hirshsprungs Disease, fecal impaction, and diarrhea.

Soaps strip away lipids, making the skin more permeable and vulnerable to diaper dermatitis. The normal pH of the skin is between 4.5-5.5. When urea from the urine and stool mix, urease breaks down the urine, increasing the hydrogen ion concentration (pH). Elevated pH levels increase the hydration of the skin and make the skin more permeable.

It was previously believed that ammonia was the primary cause of diaper dermatitis. Recent studies have disproved this, showing that when ammonia or urine is placed on the skin for 24 to 48 hours, no apparent skin damage occurs (Farrington, 1992; Berg et al., 1986). urine ammonia levels are the same in infants with or without diaper dermatitis (Farrington, 1992). Ammonia may be a secondary irritant on damaged skin, but it is probably not a primary cause of diaper dermatitis on intact skin.


The goal in the management of a diaper rash is prevention. This is achieved through maintenance of skin integrity to prevent damage to the stratum corneum, the skin's barrier. Keeping the baby dry, which entails frequent diaper changes is the ideal way to both treat and prevent irritant diaper dermatitis. The frequency of diaper dermatitis decreases in relation to the increased number of diaper changes (Jorden et al., 1986).

Soiled diapers should be changed as soon as possible. If diaper dermatitis is present, diapers should be changed at least every 2 hours during the day and once at night. If possible, the infant should go without a diaper.

Cloth diapers, diaper services, and disposable diapers are debatable and a matter of preference, convenience, time, and cost. Home washed cloth diapers and commercial laundered diapers have significant differences (Farrington, 1992). Home laundering of cloth diapers will vary. Soaking soiled diapers in washing soda (sodium carbonate), such as Arm and Hammer in cold water, will act as a laundry booster, assist in removing stains, and neutralize odors. Wash all diapers in detergent and bleach in hot water. The detergent is the cleansing agent and bleach will disinfect and whiten. Adding a laundry booster or vinegar to the wash cycle will eliminate odors, counteract ammonia, and rinse out residue. Rinse and double rinse in cold water to remove chemicals and residual detergent. Fabric softener may be added to keep the diapers soft and to prevent friction. If irritation persists, products will need to be changed. Plastic pants are occlusive and should be avoided. Diaper services will use very hot water to effectively destroy microorganisms, along with detergents, multiple rinses, and sterilization techniques (Farrington, 1992; Spraker, 2000). When selecting a disposable diaper, consider type, size, and cost. There are many varieties and sizes available. Super absorbent disposable diapers contain an absorbent gelling material (AGM) that wicks away moisture. Studies suggest that these diapers are associated with less-severe diaper rashes (Farrington, 1992; Wong, 1992). Trial and error techniques may be required, and several types or different diaper brands may need to be tested before the appropriate one is found best for the child.

5 Answers

  • 2 decades ago
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    DR 的原因論multifocal 並且疹不是唯一個體, 但皮膚的反應對幾個因素, 地方和系統(Liptak, 2001). 有幾種引起理論, 範圍從食物過敏對地層corneum 的損傷或皮膚的頂層譬如滲浸, 摩擦, 並且破裂(Liptak, 2001 年; Spraker, 2000). 水濕, 乾性皮膚, 洗滌的代理譬如肥皂, 被舉起的酸鹼度水平, 糞便酵素, 糞便無節制, 並且腹瀉由於傳染或抗藥性用途將修改皮膚正直使皮膚易受影響尿布皮炎(Liptak, 2001 年; Spraker, 2000). 泌尿無節制也許同小兒科反常現象聯繫在一起, 神經混亂, 基因綜合症狀, 並且精神創傷。 情況聯繫了糞便無節制也許有: ostomy 記下, anorectal 畸形, perineal fistula, 脊柱裂, Hirshsprungs 疾病, 糞便裝緊, 並且腹瀉。

    肥皂剝離去油脂, 使皮膚有滲透性和脆弱對尿布皮炎。 皮膚的正常酸鹼度是在4.5-5.5 之間。 當尿素從尿和凳子混合, 尿素劃分尿, 增加氫離子集中(酸鹼度) 。 被舉起的酸鹼度水平增加皮膚的水合作用和使皮膚更加有滲透性。

    它早先被相信, 氨是尿布皮炎的主要起因。 最近研究反駁了這, 顯示那氨或尿被安置在皮膚24 到48 個小時, 明顯的皮膚損傷不發生(Farrington, 1992 年; Berg 等, 1986). 尿氨水平是相同在嬰兒方面有或沒有尿布皮炎(Farrington, 1992). 氨也許是一種次要刺激劑在損壞的皮膚, 但這大概不是尿布皮炎的主要起因在原封皮膚。


    目標在尿布疹的管理是預防。 這達到通過皮膚正直維護預防損壞對於地層corneum, 皮膚的障礙。 保持嬰孩乾燥, 哪些需要頻繁尿布變動是理想的方式對款待和防止刺激性尿布皮炎。 尿布皮炎減退頻率關於尿布的增加的數字改變(Jorden 等, 1986).

    被弄髒的尿布應該儘快被換。 如果尿布皮炎是存在, 尿布應該被換至少每2 個小時日間和一次在晚上。 如果可能, 嬰兒應該去沒有尿布。

    布料尿布, 尿布服務, 並且一次性的尿布是無定論和特選事情, 便利, 時間, 並且費用。 家被洗滌的布料尿布和商業被洗滌的尿布有重大區別(Farrington, 1992). 家庭洗滌布料尿布將變化。 浸泡的被弄髒的尿布在洗滌物蘇打(碳酸鈉), 譬如胳膊和錘子在冷水裡, 作為洗衣店助推器, 協助在取消汙點, 並且中立化氣味。 洗滌所有尿布在洗滌劑和漂白在熱水裡。 洗滌劑是洗滌的代理並且漂白將消毒和將漂白。 增加洗衣店助推器或醋來洗滌週期將消滅氣味, 抵制氨, 並且沖洗在殘滓之外。 漂洗和雙重沖洗在冷水裡去除化學製品和殘餘的洗滌劑。 織品軟化劑也許增加保持尿布軟和防止摩擦。 如果激怒堅持, 產品將需要被改變。 塑料褲子是閉塞的, 應該被避免。 尿布服務將使用非常熱水有效地毀壞微生物, 與洗滌劑一起, 多沖洗, 並且絕育技術(Farrington, 1992 年; Spraker, 2000). 當選擇一塊一次性的尿布, 考慮型, 大小, 並且費用。 有許多品種和大小可利用。 超級吸收劑一次性的尿布包含吸收劑形成膠凍的材料(AGM) 那燈芯去濕氣。 研究建議, 這些尿布同嚴厲尿布疹(Farrington 聯繫在一起, 1992 年; Wong 和。al., 1992). 嘗試技術也許必需, 並且幾個型或不同的尿布品牌也許需要被測試在適當你被發現最好為孩子之前。

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  • 阿彬
    Lv 6
    2 decades ago


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  • 2 decades ago


    2005-03-22 22:56:11 補充:


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  • Anonymous
    2 decades ago

    這樣才十點, 會不會太累

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