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  • 1.
    Forsgren-Brusk, Ulla
    et al.
    SCA Hygiene Products AB, Sweden.
    Yhlen, Birgitta
    SCA Hygiene Products AB, Sweden.
    Blomqvist, Marie
    RISE - Research Institutes of Sweden, Bioscience and Materials, Agrifood and Bioscience.
    Larsson, Peter
    University of Gothenburg, Sweden; Sahlgrenska University Hospital, Sweden.
    Method for Bacterial Growth and Ammonia Production and Effect of Inhibitory Substances in Disposable Absorbent Hygiene Products2017In: Journal of Wound, Ostomy and Continence Nursing (WOCN), ISSN 1071-5754, E-ISSN 1528-3976, Vol. 44, no 1, p. 78-83Article in journal (Refereed)
    Abstract [en]

    PURPOSE:: The purpose of this study was to evaluate a pragmatic laboratory method to provide a technique for developing incontinence products better able to reduce malodor when used in the clinical setting. METHODS:: Bacterial growth and bacterially formed ammonia in disposable absorbent incontinence products was measured by adding synthetic urine inoculated with bacteria to test samples cut from the crotch area of the product. The inhibitory effectʼs of low pH (4.5 and 4.9) and 3 antimicrobial substances—chlorhexidine, polyhexamethylene biguanide (PHMB), and thymol—at 2 concentrations each, were studied. RESULTS:: From the initial inocula of 3.3 log colony-forming units per milliliter (cfu/mL) at baseline, the bacterial growth of the references increased to 5.0 to 6.0 log cfu/mL at 6 hours for Escherichia coli, Proteus mirabilis, and Enterococcus faecalis. At 12 hours there was a further increase to 7.0 to 8.9 log cfu/mL. Adjusting the pH of the superabsorbent in the incontinence product from 6.0 to pH 4.5 and pH 4.9 significantly (P < .05) inhibited the bacterial growth rates, in most cases, both at 6 and 12 hours. The effect was most pronounced at pH 4.5. Chlorhexidine had significant (P < .05) inhibitory effect on E. coli and E. faecalis, and at 12 hours also on P. mirabilis. For PHMB and thymol the results varied. At 6 hours, the ammonia concentration in the references (pH 6.0) was 200 to 300 ppm and it was 1500 to 1600 ppm at 8 hours. At pH 4.5, no or little ammonia production was measured at 6 and 8 hours. At pH 4.9, there was a significant reduction (P < .01). Chlorhexidine and PHMB exerted a significant (P < .01 or P < .001) inhibitory effect on ammonia production at both concentrations and at 6 and 8 hours. Thymol 0.003% and 0.03% showed inhibitory effect at both 6 hours (P < .01 or P < .001) and at 8 hours (P < .05 or P < .001). CONCLUSION:: The method described in this study can be used to compare the ability of various disposable absorbent products to inhibit bacterial growth and ammonia production. This technique, we describe, provides a pragmatic method for assessing the odor-inhibiting capacity of specific incontinence products.

  • 2.
    Hall, Gunnar
    et al.
    RISE - Research Institutes of Sweden, Bioscience and Materials, Agrifood and Bioscience.
    Alenljung, Susanne
    SCA Hygiene Products AB, Sweden.
    Forsgren-Brusk, Ulla
    SCA Hygiene Products AB, Sweden.
    Identification of Key Odorants in Used Disposable Absorbent Incontinence Products2017In: Journal of Wound, Ostomy and Continence Nursing (WOCN), ISSN 1071-5754, E-ISSN 1528-3976, Vol. 44, no 3, p. 269-276Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    The purpose of this study was to identify key odorants in used disposable absorbent incontinence products.

    DESIGN:

    Descriptive in vitro study SUBJECTS AND SETTING:: Samples of used incontinence products were collected from 8 residents with urinary incontinence living in geriatric nursing homes in the Gothenburg area of Sweden. Products were chosen from a larger set of products that had previously been characterized by descriptive odor analysis.

    METHODS:

    Pieces of the used incontinence products were cut from the wet area, placed in glass bottles, and kept frozen until dynamic headspace sampling of volatile compounds was completed. Gas chromatography-olfactometry was used to identify which compounds contributed most to the odors in the samples. Compounds were identified by gas chromatography-mass spectrometry.

    RESULTS:

    Twenty-eight volatiles were found to be key odorants in the used incontinence products. Twenty-six were successfully identified. They belonged to the following classes of chemical compounds: aldehydes (6); amines (1); aromatics (3); isothiocyanates (1); heterocyclics (2); ketones (6); sulfur compounds (6); and terpenes (1).

    CONCLUSION:

    Nine of the 28 key odorants were considered to be of particular importance to the odor of the used incontinence products: 3-methylbutanal, trimethylamine, cresol, guaiacol, 4,5-dimethylthiazole-S-oxide, diacetyl, dimethyl trisulfide, 5-methylthio-4-penten-2-ol, and an unidentified compound.

    This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited.

     

  • 3.
    Kanerva Rice, Sophie
    et al.
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Pendrill, Leslie
    RISE - Research Institutes of Sweden, Safety and Transport, Measurement Science and Technology.
    Petersson, Niclas
    RISE - Research Institutes of Sweden.
    Nordlinder, Jesper
    SCA Hygiene Products AB, Sweden.
    Farbrot, Anne
    SCA Hygiene Products AB, Sweden.
    Rationale and Design of a Novel Method to Assess the Usability of Body-Worn Absorbent Incontinence Care Products by Caregivers2018In: Journal of Wound, Ostomy and Continence Nursing (WOCN), ISSN 1071-5754, E-ISSN 1528-3976, Vol. 45, no 5, p. 456-464Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The purpose of this study was to develop and test a new method to measure the usability of absorbent incontinence care products from the caregivers' perspective and to investigate if the method can be used to differentiate between product types in a product change.

    DESIGN: Process evaluation and validation study.

    SUBJECTS AND SETTING: Product developers and end users participated in designing the new method. Thereafter, professional caregivers acted as testers of the new method, ranking usability when performing absorbent product changes on patients in a simulated nursing home care environment, assisted by third-party research institute moderators.

    METHODS: Design and evaluation of a new method designed to assess the usability of body-worn absorbent incontinence care products for lay caregivers were completed. The evaluation included formative and summative evaluations of effectiveness (product fit), efficiency (time and physical workload), and satisfaction. A person-centered approach aimed at including all subjects and settings to generate a single usability score for decision making and product benchmarking. Experienced caregivers changed 4 types of products: (1) disposable body-worn pads with mesh briefs (2-piece system); (2) disposable all-in-one briefs; (3) disposable, T-shaped, and belted brief; and (4) disposable pull-up pants on simulated patients in standing or lying position. Each product change was performed by 1 unassisted experienced caregiver. The probability of success as a score for each product type was calculated across the 4 metrics and reported with 95% confidence intervals (CIs). Descriptive and inferential statistics were developed assuming a binary statistical model, using the weighted scores from each of the factors. An overall usability score was calculated.

    RESULTS: The method we developed discriminated between usability of different product types. The overall score for the disposable pull-up product (90%; CI: 83%-97%) was better (P < .05) than for the disposable T-shaped brief (83%; CI: 77%-89%), the disposable brief (53%; CI: 45%-61%), and the disposable body-worn pad with mesh pant (61%; CI: 56%-66%) in standing patients. For lying patients, the overall score for the disposable T-shaped brief product (81%; CI: 73%-89% was better (P < .05) than the disposable brief (65%; CI: 45%-61%) and the disposable body-worn pads with mesh brief (62%; CI: 55%-69%). Reliability was evaluated quantitatively in terms of measurement uncertainties in the results.

    CONCLUSION: The method we described demonstrated differentiation of usability based on product type indicating concurrent validity. Further testing in diverse real-world care environments is needed to evaluate and confirm the validity and to assess reliability of this method in the research setting.

  • 4.
    Widen, Heléne
    et al.
    RISE - Research Institutes of Sweden, Bioscience and Materials, Agrifood and Bioscience.
    Alenljung, Susanne
    SCA Hygiene Products AB, Sweden.
    Forsgren-Brusk, Ulla
    SCA Hygiene Products AB, Sweden.
    Hall, Gunnar
    RISE - Research Institutes of Sweden, Bioscience and Materials, Agrifood and Bioscience.
    Sensory Characterization of Odors in Used DisposableAbsorbent Incontinence Products2017In: Journal of Wound, Ostomy and Continence Nursing (WOCN), ISSN 1071-5754, E-ISSN 1528-3976, Vol. 44, no 3, p. 277-282Article in journal (Refereed)
    Abstract [en]

    PURPOSE

    The objectives of this study were to characterize the odors of used incontinence products by descriptive analysis and to define attributes to be used in the analysis. A further objective was to investigate to what extent the odor profiles of used incontinence products differed from each other and, if possible, to group these profiles into classes.

    SUBJECTS AND SETTING

    Used incontinence products were collected from 14 residents with urinary incontinence living in geriatric nursing homes in the Gothenburg area, Sweden.

    METHODS

    Pieces were cut from the wet area of used incontinence products. They were placed in glass bottles and kept frozen until odor analysis was completed. A trained panel consisting of 8 judges experienced in this area of investigation defined terminology for odor attributes. The intensities of these attributes in the used products were determined by descriptive odor analysis. Data were analyzed both by analysis of variance (ANOVA) followed by the Tukey post hoc test and by principal component analysis and cluster analysis.

    RESULTS

    An odor wheel, with 10 descriptive attributes, was developed. The total odor intensity, and the intensities of the attributes, varied considerably between different, used incontinence products. The typical odors varied from "sweetish" to "urinal," "ammonia," and "smoked." Cluster analysis showed that the used products, based on the quantitative odor data, could be divided into 5 odor classes with different profiles.

    CONCLUSIONS

    The used products varied considerably in odor character and intensity. Findings suggest that odors in used absorptive products are caused by different types of compounds that may vary in concentration.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

     

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