Skin Conditions

Susan Cleveland's picture
Preventing MASD by Moving

by Susan Cleveland, BSN, RN, WCC, CDP, NADONA Board Secretary

The long-term care setting has changed over the years: it has become an even more concerning issue because our population is no longer just older adults looking for a place to age, but now includes a wave of acutely ill individuals with multiple comorbidities. And yet despite these changes, skin issues continue to be a problem. Moisture from any source increases the skin’s permeability and decreases the barrier function. The outmost layer of the epidermis, the stratum corneum, is normally slightly acidic and protects the body from pathogens when intact. If the skin is compromised by moisture or moisture with friction, a break in the surface can allow pathogens to enter.

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WoundSource Practice Accelerator's picture
moisture-associated skin damage

by the WoundSource Editors

It has long been known in clinical practice that long-term exposure of the skin to moisture is harmful and can lead to extensive skin breakdown. The term moisture-associated skin damage was coined as an umbrella term to describe the spectrum of skin damage that can occur over time and under various circumstances. To have a moisture-associated skin condition, there must be moisture that comes in contact with that skin.

WoundSource Practice Accelerator's picture
incontinence-associate dermatitis prevention

by the WoundSource Editors

Although clinical practice is hampered by a lack of rigorous studies, standardized terminology, or definitions of incontinence-associated skin damage, it is well known among health care providers that this damage places patients at increased risk for pressure ulcer/injury development.

WoundSource Practice Accelerator's picture
complications associated with MASD

by the WoundSource Editors

Best practice in skin care focuses on the prevention of skin breakdown and the treatment of persons with altered skin integrity. When we ask what causes skin damage we should consider the conditions that can harm the skin, including excessive moisture and overhydration, altered pH of the skin, the presence of fecal enzymes and pathogens, and characteristics of incontinence such as the volume and frequency of the output and whether the output is urine, feces, or both

WoundSource Practice Accelerator's picture
skin assessment and moisture-associated skin damage

by the WoundSource Editors

The performance of an accurate and complete skin assessment is of utmost importance to obtaining and maintaining healthy skin. Understanding the structure and function of the skin is key to the differentiation of normal from abnormal findings. Having this baseline knowledge aids in determining the patient's level of risk, how skin is damaged, the impact of moisture on the skin, the resulting type of moisture-associated skin damage (MASD), and whether current skin care protocols are effective and adequate.

WoundSource Practice Accelerator's picture

by the WoundSource Editors
Denuded: The loss of epidermis, caused by prolonged moisture and friction.

Excoriation: Linear erosion of skin tissue resulting from mechanical means.

Maceration: The softening and breaking down of skin resulting from prolonged exposure to moisture.

Holly Hovan's picture
elderly patient skin tear prevention

Holly M. Hovan MSN, APRN, ACNS-BC, CWON-AP

I'm sure you're all familiar with the terms "prednisone skin," "thin skin," "fragile skin," or "easily bruises." One or all of these phrases are commonly used to describe our geriatric population's aging skin. As we age, so does our skin. Skin loses elasticity and often gains wrinkles. Skin conditions that were maybe never present throughout life can crop up with aging. Keep in mind that the environment and different exposures (to sunlight, smoking, and stress) can cause our skin to age differently.

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Paula Erwin-Toth's picture
questions in wound care

On April 26, 2017, I presented a webinar on WoundSource.com on the topic of Moisture-Associated Skin Damage (MASD). Afterwards, there was a Q&A session with the participants of the webinar. This is a selection of some of those questions and their answers.

Martin Vera's picture
anatomy of the skin, the body's largest organ

by Martin D. Vera, LVN, CWS

On our last encounter we discussed wound bed preparation and the TIME framework. What I wish to accomplish with this post is to make it easier to understand the skin, the changes it undergoes as we age, and pave the way for the phases of wound healing—all of which are essential in becoming a better clinician.

Cheryl Carver's picture
fungi candida albicans 3D

by Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC

It doesn't matter where exactly I am educating, I see it everywhere: the vicious cycle of chronic intertrigo and or candida infections (candidiasis) of the skin in the long-term care arena. Skin and soft tissue infections are the third most common infection in long-term care.

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