Journal articlesBack to basics: understanding moisture-associated skin damage

Back to basics: understanding moisture-associated skin damage

07/11/17 | Skin integrity | Trudie Young

This article discusses the aetiology and clinical presentations of the four conditions collectively known as moisture-associated skin damage (MASD). It explores the normal status of the skin and how this is altered in the presence of excess and prolonged moisture. In all manifestations the barrier property of the skin is impaired, allowing irritants to penetrate the epidermis. Moisture damage disrupts the lipid matrix surrounding the cells in the stratum corneum and effectively dissolves the physical barrier of the skin. The pH of the skin also increases, resulting in an alkaline environment conducive to bacterial proliferation and infection. Urine and faeces are the offending contaminants in incontinence-associated dermatitis, whereas perspiration is the primary cause of intertriginous dermatitis. Effluent from the ostomy causes peristomal damage and wound exudate instigates moisture damage to the periwound skin. The clinical picture of MASD ranges from mild erythema to extensive and painful skin breakdown often complicated by bacterial and fungal infection. A structured skin-care regimen that involves cleansing, protecting and restoring the barrier properties of the skin will assist in the prevention and management of all MASD.