Comparison of the Effectiveness of New Material Diapers versus Standard Diapers for the Prevention of Diaper Rash in Chinese Babies: A Double-Blinded, Randomized, Controlled, Cross-Over Study

Chao Yuan, Rinko Takagi, Xue-Qiu Yao, Ya-Fei Xu, Koichi Ishida, Haruko Toyoshima, Chao Yuan, Rinko Takagi, Xue-Qiu Yao, Ya-Fei Xu, Koichi Ishida, Haruko Toyoshima

Abstract

Background: Diaper rash, also known as diaper dermatitis (DD), is a very common skin condition in infants, and use of disposable diapers with breathable materials is an effective approach for the management of diaper rash. In China, new material diapers and standard diapers are currently the two most commonly used disposable diapers. This study aimed to compare the effectiveness of new material diapers versus standard diaper for the prevention of diaper rash in Chinese babies.

Methods: A total of 80 eligible babies admitted to Shanghai Skin Diseases Hospital during the period from June through July, 2016, were enrolled and randomized into two groups. Babies in Group A (n = 41) used the new material diapers, and babies in Group B (n = 39) used standard diapers. Two weeks after the use of the diaper, the babies used the alternate product for the next 2 weeks. Skin conditions were assessed on the front and back waist, right and left buttock, pubic region, anal region, and right and left groin using a 6-point scoring system based on four parameters in 0, 2, and 4 weeks after use of the diapers.

Results: There were changes of the mean skin assessment score in each of the six regions after the use of the diapers. There were significant differences, in the mean skin assessment score of the front waist in Group A between weeks 2 and 4 (P = 0.006) and in Group B between weeks 0 and 2 (P = 0.004), and no significant differences were detected in the mean skin assessment score of the back waist and buttock in both Group A and Group B on weeks 0, 2, and 4. A higher mean skin assessment score of the pubic region was assessed in Group A on week 4 than on week 2 (P = 0.036), with a higher score seen on week 2 than on week 0 (P = 0.048), while no significant differences were found in Group B among weeks 0, 2, or 4. There was a higher mean score of the anal region assessed in Group A on week 2 than on week 0 (P = 0.01), while a higher mean score was found in Group B on week 2 than on weeks 0 (P = 0.036) and 4 (P = 0.01). In addition, a higher mean skin assessment score of the groin was detected on week 2 than on week 0 in both Group A (P = 0.00001) and Group B (P = 0.0001).

Conclusion: The new material diaper is superior to the standard diaper for the prevention of diaper rash in Chinese babies.

Figures

Figure 1
Figure 1
Skin assessment scores of the front (a) and back waist (b), the buttock (c), pubic region (d), anal region (e), and the groin (f) using a 6-point scoring system based on four parameters 0, 2, and 4 weeks after use of the diapers (P < 0.05; ∗∗P < 0.01).

References

    1. Klunk C., Domingues E., Wiss K. An update on diaper dermatitis. Clinics in Dermatology. 2014;32(4):477–487. doi: 10.1016/j.clindermatol.2014.02.003.
    1. Stamatas G. N., Tierney N. K. Diaper dermatitis: Etiology, manifestations, prevention, and management. Pediatric Dermatology. 2014;31(1):1–7. doi: 10.1111/pde.12245.
    1. Foureur N., Vanzo B., Meaume S., Senet P. Prospective aetiological study of diaper dermatitis in the elderly. British Journal of Dermatology. 2006;155(5):941–946. doi: 10.1111/j.1365-2133.2006.07423.x.
    1. Coughlin C. C., Eichenfield L. F., Frieden I. J. Diaper dermatitis: Clinical characteristics and differential diagnosis. Pediatric Dermatology. 2014;31(1):19–24. doi: 10.1111/pde.12500.
    1. Adalat S., Wall D., Goodyear H. Diaper dermatitis-frequency and contributory factors in hospital attending children. Pediatric Dermatology. 2007;24(5):483–488. doi: 10.1111/j.1525-1470.2007.00499.x.
    1. Scheinfeld N. Diaper dermatitis: A review and brief survey of eruptions of the diaper area. American Journal of Clinical Dermatology. 2005;6(5):273–281. doi: 10.2165/00128071-200506050-00001.
    1. Tüzün Y., Wolf R., Bağlam S., Engin B. Diaper (napkin) dermatitis: A fold (intertriginous) dermatosis. Clinics in Dermatology. 2015;33(4):477–482. doi: 10.1016/j.clindermatol.2015.04.012.
    1. Boiko S. Treatment of diaper dermatitis. Dermatologic Clinics. 1999;17(1):235–240. doi: 10.1016/S0733-8635(05)70079-6.
    1. Merrill L. Prevention, Treatment and Parent Education for Diaper Dermatitis. Nursing for Women's Health. 2015;19(4):324–337. doi: 10.1111/1751-486X.12218.
    1. Shin H. T. Diagnosis and Management of Diaper Dermatitis. Pediatric Clinics of North America. 2014;61(2):367–382. doi: 10.1016/j.pcl.2013.11.009.
    1. Odio M. R., O'Connor R. J., Sarbaugh F., Baldwin S. Continuous topical administration of a petrolatum formulation by a novel disposable diaper. 2. Effect on skin condition. Dermatology. 2000;200(3):238–243. doi: 10.1159/000018366.
    1. Odio M., Thaman L. Diapering, diaper technology, and diaper area skin health. Pediatric Dermatology. 2014;31(1):9–14. doi: 10.1111/pde.12501.
    1. Miyauchi Y., Shimaoka Y., Fujimura T. Developmental changes in neonatal and infant skin structures during the first 6 months: in vivo observation. Pediatric Dermatology. 2016;33(3):289–295. doi: 10.1111/pde.12796.
    1. Minami-Hori M., Honma M., Fujii M., et al. Developmental alterations of physical properties and components of neonatal-infantile stratum corneum of upper thighs and diaper-covered buttocks during the 1st year of life. Journal of Dermatological Science. 2014;73(1):67–73. doi: 10.1016/j.jdermsci.2013.08.015.
    1. Visscher M. O., Adam R., Brink S., Odio M. Newborn infant skin: Physiology, development, and care. Clinics in Dermatology. 2015;33(3):271–280. doi: 10.1016/j.clindermatol.2014.12.003.
    1. Telofski L. S., Morello A. P., Mack Correa M. C., Stamatas G. N. The Infant Skin Barrier: Can We Preserve, Protect, and Enhance the Barrier? Dermatology Research and Practice. 2012;2012:18. doi: 10.1155/2012/198789.198789
    1. Seymour J. L., Keswick B. H., Milligan M. C., Jordan W. P., Hanifin J. M. Clinical and microbial effects of cloth, cellulose core, and cellulose core/absorbent gel diapers in atopic dermatitis. Pediatrician. 1987;14(1):39–43.
    1. Seymour J. L., Keswick B. H., Hanifin J. M., Jordan W. P., Milligan M. C. Clinical effects of diaper types on the skin of normal infants and infants with atopic dermatitis. Journal of the American Academy of Dermatology. 1987;17(6):988–997. doi: 10.1016/S0190-9622(87)70288-6.
    1. Liu N., Wang X., Odio M. Frequency and severity of diaper dermatitis with use of traditional Chinese cloth diapers: Observations in 3- to 9-month-old children. Pediatric Dermatology. 2011;28(4):380–386. doi: 10.1111/j.1525-1470.2011.01494.x.
    1. Kamat M., Malkani R. Disposable Diapers: A Hygienic Alternative. The Indian Journal of Pediatrics. 2003;70(11):879–881. doi: 10.1007/BF02730591.
    1. Singh N., Purthi P. K., Sachdev A., Gupta S. Disposable Diapers: Safe and Effective. The Indian Journal of Pediatrics. 2003;70(9):721–722. doi: 10.1007/BF02724314.
    1. Erasala G. N., Romain C., Merlay I. Diaper area and disposable diapers. Topical Applications and the Mucosa. 2011;40:83–89.
    1. Lukowski A. F., Liu X., Peirano P., Odio M., Bauer P. J. Disposable diaper use promotes consolidated nighttime sleep and positive mother-infant interactions in Chinese 6-month-olds. Journal of Family Psychology. 2015;29(3):371–381. doi: 10.1037/fam0000072.
    1. Stein H. Incidence of diaper rash when using cloth and disposable diapers. Journal of Pediatrics. 1982;101(5):721–723. doi: 10.1016/S0022-3476(82)80299-0.
    1. Erasala G.-N., Merlay I., Romain C. Evolution of disposable diapers and reduction of diaper dermatitis. Archives de Pédiatrie. 2007;14(5):495–500. doi: 10.1016/j.arcped.2007.03.002.
    1. Akin F., Spraker M., Aly R., Leyden J., Raynor W., Landin W. Effects of breathable disposable diapers: Reduced prevalence of Candida and common diaper dermatitis. Pediatric Dermatology. 2001;18(4):282–290. doi: 10.1046/j.1525-1470.2001.01929.x.
    1. Davis J. A., Leyden J. J., Grove G. L., Raynor W. J. Comparison of Disposable Diapers with Fluff Absorbent and Fluff Plus Absorbent Polymers: Effects on Skin Hydration, Skin pH, and Diaper Dermatitis. Pediatric Dermatology. 1989;6(2):102–108. doi: 10.1111/j.1525-1470.1989.tb01005.x.
    1. Yuan C., Wang X.-M., Galzote C., et al. Meteorology and ethnicity as critical factors in HRIPT: Comparing responses between Chinese and Indian ethnicities. Regulatory Toxicology and Pharmacology. 2013;66(1):59–65. doi: 10.1016/j.yrtph.2013.02.009.

Source: PubMed

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