Moisture Associated Skin Damage Masterclass GUIDES

Introduction

This Masterclass Guide is a concise overview of Moisture Associated

Skin Damage (MASD). MASD occurs when skin is exposed to moisture for prolonged periods of time, resulting in over-hydrated or eroded skin. This leads to trans epidermal water loss (TEWL) and an elevated skin pH that reduces the skin’s ability to maintain its barrier function.4,5 The end result is separation of the skin layers, which is also known as maceration.

What Are the Risk Factors for MASD?

Body/ Body Fluids

■ Direct skin contact with urine and/ or (liquid) faeces

■ Sweat on the skin surface

■ (Increased) wound secretions on the skin surface

■ Other body fluids such as mucus, (tracheal) secretions, or saliva on the skin surface

■ Increased dermal metabolism, elevated local temperature, abnormal skin pH, history of atopy, genetic susceptibility to contaminants, irritants, deep body folds, dermal atrophy, and inadequate sebum production

■ Pressure related injuries, such as immersion foot

Skin cleansing procedures and products

■ Repeated or excessive skin cleansing, strong friction or abrasive drying procedures, use of rough materials such as coarse towels

■ Repeated use of harsh skin cleansers

■ Ingredients in skin cleansers such as anionic tensides, fragrances, alcohol, preservatives, essential oils

Mechanical factors

■ Mechanical irritation (friction) from clothing or in skin folds

■ Occlusion, for example due to long periods of lying on non-breathable materials, wearing non-breathable clothing, incontinence pads

■ Pressure or shear forces

■ Skin damage from adhesive products, such as band-aids

Indirect risk factors

■ Old age

■ Care dependency

■ Immobility

■ Malnutrition

■ Obesity

■ Atopic diathesis

■ Microangiopathy and/ or macroangiopathy

■ Reduced sensory functions such as blindness, polyneuropathy, dementia

■ Immunosuppression

Keywords

■ Wound

■ Wounds

■ Wound care

■ Moisture associated skin damage (MASD)

■ Trans epidermal water loss (TEWL)

■ Epidermal injury

■ Medical-adhesive-related skin injury (MARSI)

How Can MASD Be Prevented?

■ As the onset of MASD often goes undetected, it may first present as basic inflammation of the skin with or without skin breakdown7,8

■ It is often only when significant inflammation, maceration and/ or skin breakdown emerges that clinicians are able to notice and intervene

■ Protection from MASD can be achieved via the application of natural moisturizers containing pyrrolidone carboxylicacid, urocanicacid, propylene glycol, lactic acid, urea, dimethicone, and petrolatum9,10

■ Preventing MASD with barrier ointments and cyanoacrylates is key for at-risk skin and managing alterations to skin integrity such as IAD, ITD, and peri wound skin damage9,10

■ Preventing MASD requires replenishing the natural moisture of the skin with moisturizing products such as skin barrier ointments. The skin should be kept clean and free of excess moisture, and a moisturizer or skin barrier cream should be applied daily