Periwound skin care considerations for older adults

Abstract

Samantha Holloway and Kirsty Mahoney discuss the unique ageing effects on adult skin and how these changes can cause the skin to be more prone to damage This article discusses the effects of ageing on the skin, particularly the main structural and functional changes that occur in the epidermis and dermis that make the skin more vulnerable to damage. Specific alterations that occur with ageing include slower epidermal turnover, flattening of the epidermal-dermal junction, loss of moisture and hydration as well as reduced immunity placing the skin at increased risk of damage. The discussion will also examine common periwound complications associated with ageing including; maceration, excoriation, dry skin, hyperkeratosis, callus, contact dermatitis and eczema. Strategies to manage these problems and interventions to reduce the risk of these complications include moisturising the skin to make it more resilient, debriding keratinised and callus tissue in the periwound area, appropriate choice of dressings to manage excessive exudate, careful removal of dressings as well as treating inflammatory conditions of the periwound skin.

The importance of periwound skin in wound healing: an overview of the evidence

“…Consideration or treatment of the peri-wound skin is, in many cases, an after-thought or completely overlooked, 4 even though the peri-wound skin can influence wound bed preparation and wound healing. 10 Conversely, disruption of the peri-wound skin can adversely affect healing: the disruptions include maceration, 11 excoriation, 12 drying-out, 13 eczema/dermatitis, 14 trauma e.g., skin stripping, 15 allergic reactions, 16 infection 17 and blistering. 18 The International Skin Tear Advisory Panel (ISTAP) identified the importance of an evidence based approach to prevention and management of peri-wound skin complications, in their 2021 Best Practice Document.…”