(CS-137) The use of a pure hypochlorous acid (pHA) preserved cleanser in the management of Irritant Contact Dermatitis (ICD) in an inpatient setting.

The use of pure hypochlorous acid (pHA) based cleanser in the management of serious wounds is evidence based and widely known but its use for continence issues is lesser known. In two regional hospitals within our system, WOCN consults include patients with varying skin damage from urine and other bodily fluids.  The condition Irritant Contact Dermatitis (ICD – formerly MASD) can lead to the development of serious wounds such as pressure injuries.  We describe here the extent of our usage of pHA in this common condition as such usage has not been thoroughly reported in clinical literature.

Methods: We reviewed consultation details of our patients in a 60-day period and analyzed the details of the conditions of ICD included in our review.  We noted patient demographics, associated causes of the ICD, percent of patients that received pHA treatment and length of treatment.

Results: In a 60-day period, there were 17 consults for ICD.  Of these cases, eight were treated with pHA cleansing solution.  The average length of pHA use on these patients was seven days, excluding one outlier that has been undergoing treatment with pHA for 56 days for fistula issues. One patient stated that pHA gave him a burning sensation previously and declined any use.  The condition improved in 87% of cases.  Details are presented in a tabular fashion of the patients we treated for ICD with pHA. Two cases are presented where ICD was improved using pHA.

Discussion: A review of these cases showed differences in the preferred methods of treatment between the WOCNs as there is no current practice guideline in place for these conditions at our facilities. The data also showed that the choice to select pHA was used more often for more extensive ICD with open skin. There were several items that were utilized in conjunction with pHA treatment showing that pHA can work well as a supportive treatment for ICD issues. This data serves as our baseline for further study into this issue. We hope to show that even small hospitals can make big impacts on national data.