An empirical study of the "Sandwich Method" in the management of moderately severe incontinence-associated dermatitis in critically ill patients: An empirical randomized controlled study.

OBJECTIVE: To evaluate the clinical efficacy and safety of a combined regimen (termed the "Sandwich Method") utilizing ethacridine lactate, growth factors, and zinc oxide paste for the prevention and management of moderately severe incontinence-associated dermatitis (IAD) in critically ill patients. METHODS: A total of 84 patients with IAD (including moderate-severe IAD and mild IAD with a PAT score ≥7) admitted to the emergency intensive care unit of a tertiary hospital in Beijing from May 2024 to April 2025 were randomly assigned to an intervention group (n = 42) and a control group (n = 42) by a random number table. The intervention group received the "Sandwich Method," which involved sequential application of ethacridine lactate-soaked gauze, growth factor spray, and zinc oxide paste. The control group received conventional care, including routine cleansing and application of tannic acid ointment. Outcomes assessed included healing rate, effective rate, mean healing time, and improvement in IAD severity (measured via the Incontinence-Associated Dermatitis Severity [IADS] score). RESULTS: Baseline characteristics were comparable between groups (P > 0.05). Post-intervention, the intervention group demonstrated superior outcomes: healing rate increased from 50% (control) to 71% (P < 0.05), mean healing time decreased from 8.83 ± 2.82 days (control) to 5.17 ± 1.06 days (P < 0.05), the degree of improvement in IAD scores was markedly greater in the intervention group (21.04 ± 7.29) compared to the control group (17.12 ± 11.44, P < 0.05) and daily IADS score reduction was significantly greater (4.02 ± 1.41 vs. 2.06 ± 1.27, P < 0.05). Additionally, no cases of progression from mild to moderate-severe IAD occurred in the intervention group, compared to 12% (5 cases) in the control group (P < 0.05). The effective rates were 95% (observation) and 86% (control), with no statistical significance (P > 0.05). CONCLUSION: The "Sandwich Method" significantly enhances healing outcomes, shortens recovery time, and prevents disease progression in moderately severe IAD. Its structured, cost-effective protocol offers practical guidance for clinical application.