Published research has supported the use of disposable products rather than cloth products for both skin integrity and cost. However, until this study, no research has examined the skin integrity or cost implications between diapers and underpads. A randomized clinical trial was conducted at three acute care facilities between August and December 1993 to compare skin integrity maintenance between patients managed with diapers and those managed with underpads. The 166 patients were divided into five groups: polymer or nonpolymer underpads, polyer or nonpolymer diapers, and cloth underpads. Among other results, total scores ranked cloth underpads as having the most severely altered skin, followed by nonpolymer diapers, and nonpolymer underpads, respectively. When looking at total scores, polymer products, whether diaper or underpad, appeared to have been a factor in preventing skin breakdown. There was no significant differences between the polymer diaper group and the polymer underpad group. The findings of this study support previous research suggesting that gel-absorption material or polymers are successful in decreasing the incidence of perineal dermatitis. The results also dispute the assumption that all containment products are equally as effective in preventing skin integrity problems.

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