Moisture-associated skin damage: causes and an overview of assessment, classification and management

Abstract

Moisture-associated skin damage (MASD) can result when the skin has prolonged or continuous exposure to excessive moisture. If the skin experiences too much moisture, it becomes overhydrated and is prone to maceration. This makes it easier for irritants and microorganisms to penetrate the skin, reduce its integrity to mechanical forces and disrupt its protective acid mantle. The condition can greatly affect patient wellbeing. MASD is a collective definition and it has four main causes: incontinence-associated dermatitis, periwound skin damage, intertriginous dermatitis and peristomal moisture-associated dermatitis. Practitioners can use tools such as the Skin Moisture Alert Reporting Tool (S.M.A.R.T.) to identify its aetiology, which informs its management. Management of MASD involves assessment, addressing the underlying cause, and implementing a structured skin care regimen to treat it and prevent its recurrence. Case studies illustrate the use of a structured treatment strategy using Medi Derma barrier products and the principles of Total Barrier Protection to provide a cost-effective solution for the prevention and management of skin compromised by MASD.

Prevention and Care for Incontinence-Associated Dermatitis Among Older Adults: A Systematic Review

“…The critical appraisal scores of the six literature reviews were4 27 and5 2 , 8 , 28–30 out of a possible 6 points ( Table 3 ). Scores for the two case reports were5 1 and6 10 out of an 8 possible points ( Table 4 ). Four articles were graded for level of quality.…”

“…Four articles were graded for level of quality. Two of those had low methodological quality, 1 , 10 and two had moderate methodological quality 24 , 25 ( Table 5 ).…”

“… Does the Case Report Provide Takeaway Lessons? Beldon, P. (2012)/(5/8) 1 Y N Y Y Y Y N N Parnham, Copson, and Loban (2020)/(6/8) 10 Y Y Y Y Y Y N N Notes : *Checklist reproduced from: Moola S., Munn Z, Tufanaru C et al Chapter 7: Systematic reviews of etiology and risk. In: Aromataris E, Munn Z, editors.…”

“…Two were in 2012; 1 , 24 one in 2013; 26 three in 2017; 25 , 27 , 28 two in 2018; 29 , 30 two in 2019; 2 , 8 and one in 2020. 10 Six articles were from the United Kingdom, 1 , 2 , 8 , 10 , 29 , 30 two from Japan, 24 , 25 two from Thailand, 27 , 28 and one from a multi-site setting. 26 The number of participants for the studies ranged from 3 to 1618 older adults.…”

“…When older adults experience urinary and fecal incontinence together with the aging processes, the combination of noxious chemicals and moisture stimulates IAD. 8 , 10 Therefore, older adults’ skin becomes more susceptible to breakdown, leading to a higher incident rate of IAD in this population.…”