Moisture-Associated Skin Damage: What is it?

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Scar Tissue wound careMoisture-Associated Skin Damage, also known by the acronym MASD, is a term that applies to the inflammation or erosion of skin, caused by prolonged exposure to moisture. In this article we’ll discuss how MASD occurs and how to prevent it. 

What is Moisture-Associated Skin Damage? 

Moisture-Associated Skin Damage is damage to the skin that happens because of too much moisture. The skin has a natural moisture barrier which plays an important role in our body’s ability to maintain homeostasis as it regulates the movement and absorption of water. When the skin is exposed to excessive amounts of moisture, there are various natural reactions. The skin may soften, swell, or become wrinkled. When there’s way too much moisture, the skin will macerate.

Moisture Sources

Additionally, for the damage to be considered MASD, another complicating factor must also be present. These factors make the skin more susceptible to moisture-associated damage. 

Complicating Factors

  • Friction caused by a variety of factors, including bed sheets. 
  • Irritation caused by the use of chemicals and other irritants. 
  • The presence of microorganisms, bacteria or other microbial factors. 

What are the Four Types of Moisture-Associated Skin Damage? 

The four types of moisture-associated skin damage are:

What is Periwound Moisture-Associated Dermatitis?

Scar Tissue wound care ocExudate is normally produced during the inflammatory stage of wound healing, however, a large amount of exudate is suboptimal and can cause the breakdown and maceration of the periwound. Breakdown is made worse by the presence of bacteria and proteolytic enzymes. Another contributor to skin damage is aggressive band-aid removal. Adhesive wound dressings should be removed slowly and with care, otherwize the integrity of the skin barrier may be compromised, as pieces of the epidermis are stripped away.  The best way to manage periwound moisture-associated dermatitis is to manage exudate by using absorptive dressings. 

What are the Risk Factors? 

There are specific types of wounds that are more prone to this type of skin damage. If the wound is also infected, this will make skin damage worse. Here are some of the risk factors for skin damage of the periwound. 

  • Foot ulcers, especially diabetic foot ulcers
  • Venous leg ulcers
  • All other types of pressure ulcers 
  • Full-thickness burns 

What is Peristomal Moisture-Associated Dermatitis?

To prevent this type of damage, healthcare providers put solid skin barriers around the stoma. However, if too much moisture is absorbed, the barrier becomes defective thus leading to damage and maceration. 

What are the Risk Factors? 

  • Protrusion of the stoma
  • Changing positions, which causes the skin to crease beneath the barrier
  • Poor pouching technique 
  • Excessive wear time 
  • External moisture, such as sweating, showering and swimming

What is Incontinence-Associated Dermatitis? 

Incontinence-Associated Dermatitis or IAD happens when urine or stool comes into contact with the skin. It is a chemical reaction to the ammonia found in urine and the enzymes found in stool. These chemicals disrupt the skin’s acid mantle, causing breakdown. This condition is made worse by maceration. 

What are the Risk Factors? 

  • Incontinence – specifically mixed urinary and fecal incontinence 
  • Fecal incontinence 
  • Inability to properly toilet
  • Use of diapers and absorbent products, as they can lead to maceration from excessive occlusion. 

What is Intertriginous Dermatitis?

Intertriginous dermatitis, also known as intertrigo or ITD happens when sweat gets trapped in the folds of the skin. This happens when there is minimal air circulation and therefore the air is unable to circulate or evaporate. Because of this, the stratum corneum becomes too hydrated, and, with added friction, becomes macerated, usually on both sides of the fold. The result is skin inflammation and denuding. The skin may also become prone to infection. 

Scar Tissue wound care orange countyWhat are the Risk Factors? 

  • Obesity or extreme weight gain 
  • Diabetic conditions, including diabetes mellitus
  • Mixed fecal and urinary incontinence 
  • Bad hygiene 
  • Hyperhidrosis 
  • Poor nutrition 
  • Drooling 
  • Individuals who are bedridden are especially at risk. 

In Conclusion: The Goal of Treatment 

When it comes to any of these conditions, the goal of treatment is always to minimize moisture and friction. By doing that, there is a less of a chance of maceration and therefore less of a chance of moisture-associated damage. Also, keep skin folds clean and treat any infections with topical or oral medicine. Weight loss may help prevent some of these conditions. 

Contact Wound Care OC for wound treatment in Orange County, CA

Dr. Faried Banimahd is a board-certified physician specializing in emergency medicine, wound care, and pain management. Our team will work with you to create an individualized treatment plan that meets your needs and unique conditions. Our clinic includes highly trained and experienced physicians, registered nurses, and certified medical staff who work together to provide you with the highest standards of wound care treatments.

To make an appointment

1533 E 4th St,

Santa Ana, CA 92701

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