Disposable nappies for preventing napkin dermatitis in infants

 

Abstract

Background

Napkin dermatitis is a common condition that occurs in otherwise healthy infants. It causes discomfort to infants, anxiety to parents and caregivers and contributes to the load on the health care system. A large variety of napkins, both disposable and non-disposable, are available. Evidence is required to assist carers and health care workers in making informed decisions when balancing the pros and cons of different napkin choices.

Objectives

To assess whether disposable napkins prevent napkin dermatitis in infants.

Search methods

We searched the Skin Group Specialised Register (up to June 2003), the Cochrane Central Register of Controlled Trials in (The Cochrane Library, Issue 3, 2004), MEDLINE (from 1966 to November 2004), EMBASE (from 1980 to February 2003) and CINAHL (from 1982 to November 2004). We searched reference lists of articles. We contacted lead investigators in the area and companies that manufacture disposable napkins for access to unpublished trials.

Selection criteria

Randomised controlled trials in which disposable napkins were compared with other types of disposable napkins or non-disposable napkins, in infants up to two years of age, for preventing napkin dermatitis.

Data collection and analysis

Two authors independently extracted data. The same two authors independently assessed trials for methodological quality. Attempts were made to contact trial authors of the trials identified for clarification of methods and results of published trials.

Main results

We identified 28 studies of the effects of various napkin types on napkin dermatitis. Seventeen studies from nine reports were included. Eleven studies were excluded due to methodology that did not fit the inclusion criteria of this review. Due to the poor reporting of methodology and results of the studies found in this review, there were no quantitative data available for analysis (or meta-analysis). Although the included studies appeared to favour cellulose-core disposable napkins over cloth, absorbent gelling material over cellulose-only core napkins, breathable outer shell over occlusive outer shell napkins and linings impregnated with formulations over plain linings, all of these studies were open to bias due to flawed methodology.

Authors' conclusions

There is not enough evidence from good quality randomised controlled trials to support or refute the use and type of disposable napkins for the prevention of napkin dermatitis in infants.

 

Plain language summary

Diposable nappies for preventing nappy rash in babies and infants.

The role of disposable napkins for preventing napkin dermatitis in infants is not yet clear. Although generally not a serious condition, napkin dermatitis is common and causes discomfort for infants, anxiety for carers and burdens the health care system. A variety of napkins are available. Carers and health care workers require evidence to assist in the choice of napkins used. This review found that there was not enough evidence from good quality randomised controlled trials to support or refute the use and type of disposable napkins for the prevention of napkin dermatitis in infants. Better studies need to be done.

 

摘要

背景

拋棄性尿布對嬰兒尿布疹的預防

尿布疹是一種正常嬰兒也很常見的疾病。它可以造成嬰兒的不舒服感，同時造成家長的焦慮，造成醫護照顧的負擔。目前有非常多種類的尿布可以選擇，不論是拋棄式或是重覆使用式。這個研究是希望讓我們在選擇這些尿布時，可以有多點瞭解，也多些證據去選擇。

目標

決定拋棄性尿布是否對嬰兒尿布疹的預防有幫助

搜尋策略

我們尋找了Skin Group Specialised Register (up to June 2003), the Cochrane Central Register of Controlled Trials in (The Cochrane Library, Issue 3, 2004), MEDLINE (從1966到 2004年11月), EMBASE (從1980到2003年二月) and CINAHL (從1982到2004年11月) ，我們檢索列出的參考文獻，且聯絡製造拋棄式尿布的廠商、計畫主持人以取得未公開的資料。

選擇標準

隨機對照試驗來比較2歲內的嬰兒，使用拋棄式或是重覆使用的尿布，是否有幫助預防尿布疹的作用。

資料收集與分析

兩名作者分別取得資料、評估資料，也試著聯絡試驗主持人，以瞭解試驗方式及結果。

主要結論

一共有28個試驗被發現研究尿布造成尿布疹的關連性。 17個試驗從9篇文章中被選出，其中11個試驗因為不符合標準而被排除。因為選錄文章的結果或是方法不良，所以不能有數量分析、統合分析。但仍發現纖維素核製成的尿布較布料好，膠凝材料又比單純纖維素製好，外膜可透氣又較封閉式好，經配方浸漬過的襯裡較好。所有的實驗因研究方法不良，都可能有結果偏差。

作者結論

目前仍沒有好的隨機對照實驗，來支持或推翻拋棄性尿布是否對嬰兒尿布疹的預防有幫助。

翻譯人

本摘要由馬偕醫院謝志偉翻譯。

此翻譯計畫由臺灣國家衛生研究院 (National Health Research Institutes, Taiwan) 統籌。

總結

拋棄性尿布對嬰兒尿布疹的預防角色目前仍不清楚。尿布疹是一種不嚴重，但造成嬰兒的不舒服感，同時造成家長的焦慮，造成醫護照顧的負擔。目前有非常多種類的尿布可以選擇，不論是拋棄式或是重覆使用式。這個研究是希望讓我們在選擇這些尿布時，可以有多點瞭解，也多些證據去選擇。可惜目前仍不足以證實拋棄性尿布是否對嬰兒尿布疹的預防有幫助。需要更佳的研究來證實。