See the impact of Moisture-Associated Skin Damage (MASD). Get recommendations to help manage patient skin.
Maintaining skin integrity is vital for patient care, as skin is the body's first line defense against the invasion of microorganisms and numerous environmental threats.
Moisture-associated skin damage (MASD) is a complex and common condition that can create negative patient experiences and increase the cost of care.¹
MASD is caused by prolonged exposure to moisture including, but not limited to wound exudate, perspiration, urine and stool and saliva. This continued exposure can result in multiple conditions of MASD; Incontinence-associated dermatitis, intertriginous dermatitis, periwound moisture associated dermatitis and peristomal moisture associated dermatitis.
Individuals with MASD experience persistent symptoms that affect quality of life, including pain, burning and pruritis.²,³
IAD prevalence is as high as 45.7%.⁴
IAD patients are 5.1 times more likely to develop a Hospital Acquired Pressure Injury.⁴
Patients with peristomal skin complications are 55.7% more likely to be readmitted to a hospital.⁵
Interdigital intertrigo can lead to severe osteomyelitis causing pain so severe that the patient is unable to ambulate.⁶
Intertriginous dermatitis (also known as intertrigo) is a clinical inflammatory condition that develops in opposing skin surfaces in response to friction, humidity, and reduced air circulation – i.e. inflammation resulting from bodily fluids trapped in skin folds subjected to friction.
Peristomal dermatitis refers to skin damage where there is a clear interaction between the skin and the stoma effluent/fluids. This results in inflammation or erosion of the skin due to moisture from fecal, urinary, and chemical irritants beginning at the mucocutaneous junction, which can then spread outwards to affect the surrounding skin.
Periwound maceration can occur when exudate overwhelms existing dressings or when adhesive dressings are repeatedly applied and removed.
Identifying the etiology is the first crucial step in managing moist skin. This reference tool can help you quickly diagnose, accurately chart, and manage MASD. Fewer charting errors can help you provide accurate and effective care for your patients and help lower the overall cost of care.
In 2020 a group of international experts collaborated to formulate best practice principles and guidelines for the prevention and management of MASD.
Use these guidelines to help you:
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1. Brennan MR, Milne CT, Agrell-Kann M, Ekholm BP. Clinical Evaluation of a Skin Protectant for the Management of Incontinence Associated Dermatitis: An Open-Label, Nonrandomized, Prospective Study. J Wound Ostomy Continence Nurs. 2017;44(2):172-180. doi:10.1097/WON.0000000000000307
2. Gray M, Black JM, Baharestani MM et al (2011) Moistureassociated skin damage: overview and pathophysiology . J Wound Ostomy Continence Nurs 38(3): 233-41
3. Woo KY, Beeckman D, Chakravarthy D (2017) Managementof moisture-associated skin damage: A scoping review. Adv Skin Wound Care 30(11): 494-501
4. Kayser, S. A., Koloms, K., Murray, A., Khawar, W., & Gray, M. (2021). Incontinence and Incontinence-Associated Dermatitis in Acute Care: A Retrospective Analysis of Total Cost of Care and Patient Outcomes From the Premier Healthcare Database. Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society, 48(6), 545–552. https://doi.org/10.1097/WON.0000000000000818
5. Taneja, C., Netsch, D., Rolstad, B. S., Inglese, G., Eaves, D., & Oster, G. (2019). Risk and Economic Burden of Peristomal Skin Complications Following Ostomy Surgery. Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society, 46(2), 143–149. https://doi.org/10.1097/WON.0000000000000509
6. MONICA G. KALRA, DO, Methodist Health System of Dallas, Dallas, Texas; KIM E. HIGGINS, DO, Physician Senior Services, Dallas, Texas; BRUCE S. KINNEY, DO, Methodist Health System of Dallas, Dallas, Texas; Am Fam Physician. 2014 Apr 1;89(7):569-573.