Q: What should I know about moisture-associated skin damage?
A: Older adults’ internal milieu is often based on homeostenosis, instead of homeostasis. For example, their normal skin health can be interrupted even by small changes such as increased moisture or decreased lubrication on the skin.
For our population, moisture-associated skin damage (MASD) causes significant risks to one’s health, potentially leading to wounds or infection. It is crucial for administrative leaders to understand the etiology and management of this condition to prevent harm to the patients and facility.
Research has shown that aggressively cleaning a patient’s skin with certain cleansing agents may lead to worsening of MASD due to the removal of natural lubricants. In addition, overexposure of the skin to body fluids (wet or soiled briefs not changed timely) and chemical irritants can cause irritant dermatitis and other complications.
MASD is divided into four key areas: incontinence-associated dermatitis (IAD), peristomal dermatitis, Intertriginous dermatitis (intertrigo), and peri wound maceration. ICD-10 diagnostic coding adds more clarification based on the types of irritant contact dermatitis. Accurate identification of the irritant, causation, microorganisms, and internal and external factors is crucial for further assessment, intervention, and timely treatment for prompt healing.
External factors that contribute to worsening of dermatitis include, but are not limited to, frequency and volume of the irritant, food and/or drugs in the urine, mechanical force, poor skin integrity, types and frequency of washing, use of occlusive products or cleansing agents, compromised mobility, critical illness, immunocompromised status and cognitive deficits.
Skin is the largest organ of the body, and we still have a lot to learn about it when it ages.
From the July/August 2024 Issue of McKnight's Long-Term Care News
