Application of a structured perianal skin protection protocol incorporating individualized nutritional support for incontinence-associated dermatitis in active Crohn’s disease patients with diarrhea

This study evaluates the effect of a structured perianal skin protection protocol based on individualized nutritional intervention on diarrhea-related incontinence-associated dermatitis (IAD) in patients with active Crohn’s disease (CD). This retrospective cohort study included 200 active CD patients with diarrhea admitted from January 2023 to December 2025. Based on protocol implementation timing, patients were divided into a control group (January 2023–June 2024, n = 123) receiving routine perianal care, and an observation group (July 2024–December 2025, n = 77) receiving structured skin care plus individualized nutritional intervention. Propensity score matching yielded 65 matched pairs. IAD incidence, severity, perianal skin score, pain score, nutritional indicators, hospital stay, and costs were compared. Multivariate logistic regression analyzed IAD risk factors. After matching, the observation group showed significantly lower IAD incidence (30.8% vs 49.2%, P = .032) and better severity distribution ( P = .031). Perineal skin condition score (5.1 ± 1.7 vs 8.3 ± 2.2) and pain NRS score (2.0 ± 1.0 vs 3.7 ± 1.4) were significantly lower in the observation group ( P < .001). At discharge, albumin (38.5 ± 4.2 g/L vs 34.2 ± 4.1 g/L) and prealbumin (242.1 ± 50.3 mg/L vs 190.2 ± 46.5 mg/L) were significantly higher in the observation group ( P < .001). Hospital stay was significantly shorter in the observation group (12.8 ± 4.1 days vs 16.5 ± 5.0 days, P < .001), with no significant difference in costs ( P = .133). The observation protocol was an independent protective factor against IAD (OR = 0.38, 95%CI: 0.19–0.74, P = .004). The structured perianal skin protection protocol incorporating individualized nutritional support was associated with reduced IAD incidence and improved clinical outcomes in active CD patients with diarrhea.