periwound maceration treatment

Maceration occurs when too much moisture is trapped between the wound and its bandage--sometimes the exudate (seepage of biological waste from the wound) escapes and gets trapped under the bandage, and sometimes the wound itself becomes overly moist. Many are able to decrease the amount of fluid pooling under the wound dressing, thus decreasing the risk of skin breakdown. There is, at present, no evidence that moist wound healing is related to the development of maceration (van Rijswijk and Harding, 2000). International Journal of Cosmetic Science 8: 253-264. VLU that were seen during 8 or more weekly clinic visits were identified;35 who had periwound maceration noted during 4 or more visits were compared with 35 matched controls who demonstrated maceration on 0 … Degradation of the wound bed may result from protease activity together with excoriation of the peri-wound skin. There has been extensive research on how to prevent skin care-related skin breakdown, and most research agrees on a few main components. Peters, J. Wounds that tend to be ‘wet’ may benefit from alginate, foam, hydrofibre or hydropolymer dressings. Proper care taken while dressing the wound reduces the risk of maceration of skin around the wound. Maceration is defined as a softening or over-hydration of the tissue due to retention of excessive moisture (Cutting, 1999b). Vowden, K., Vowden, P. (2002)Wound bed preparation. - Leg elevation and compression, as appropriate. Although precise recurrence rates can be difficult to... By Susan M. Cleveland, BSN, RN, WCC, CDP, NADONA Board Secretary. In: Miller, M., Glover, D. (eds). Protect periwound skin. Regular applications of liquid paraffin/soft paraffin (50/50 proportions) or zinc oxide cream or ointment BP to the peri-ulcer skin are often soothing as well as protective in function. Health-care professionals need to be aware of maceration and the implications it may have for wound healing. Heavily draining wounds or the improper use of a moist dressing can lead to maceration of the periwound skin, altering tissue tolerance and damaging the wound edges. wound fluid, sweat, urine) for prolonged periods, which can cause the skin to become soft/soggy. This model for healing emphasises a number of objectives: - To achieve a well-vascularised wound bed, - To decrease the bio-burden of the wound. Upper Saddle River, New Jersey: Pearson Prentice Hall; 2008:128-130. Nursing Times 96: 45, 35-36. However, partially occlusive dressings that rely on absorbency and moisture vapour transmission rate (MVTR) for their fluid-handling capabilities may offer a lower risk of inducing maceration. It presents as a pale, opaque rim surrounding the wound. A macerated wound is an injury accompanied by soft, white, deteriorating skin around the site of the original injury. As a clinician practicing in the outpatient and home care settings, it was not unusual for patients to have to take a "holiday" from negative pressure. The eyes of the care providers tend to go direct to the center of the wound, the wound bed. Note the maceration to the peri-wound area. Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS, is a Certified Wound Therapist and enterostomal therapist, founder and president of WoundEducators.com, and advocate of incorporating digital and computer technology into the field of wound care. They can be used on intact skin, but are most commonly used to prevent further skin breakdown in areas of incontinence. When presented with a wound, you should identify risk factors that may lead to periwound damage or breakdown and plan your care accordingly, taking care to choose an appropriate dressing and apply a skin sealant or moisture barrier as necessary. Educational leaflet. It is important to treat the condition especially in elderly and immobile patients, or else there is associated risk of infection. Additional approaches to managing exudate include the use of: - Topical corticosteroids (anti-inflammatory and vasoconstrictive in action). Voegeli D. Moisture-associated skin damage: an overview for community nurses. 2nd edition. Lamke, LO., Nilsson, G.E., Reitherner, H.L. Excoriation › Excoriation occurs when periwound skin … Lawton S, Langoen A. Assessing and managing vulnerable periwound skin. Important Notice: The contents of the website such as text, graphics, images, and other materials contained on the website ("Content") are for informational purposes only. Michael N. Desvigne, MD, FACS, CWS, FACCWS, Kevin F. Ackermann, Vice President of Healthcare, Medela. The wound assessment should include the periwound and surrounding skin, extending 4cm from the wound bed.1 Assessing wound location, shape, color, edges, margins, periwound, and surrounding skin is most significant in a thorough wound evaluation.1,2The periwound and wound margins are good indicators for identifying the wound type, infection, and moisture balance and for managing the plan of care.1,3 A per… London: Emap Healthcare. In acute wounds, exudate components contribute positively to the wound-healing process. Any wound care provider is going to continuously seek new approaches to wound therapies that improve patient healing times. Excessive amounts of wound exudate can cause the periwound (within 4 cm of wound edge) skin to become macerated and even break down. , hydrofibre or hydropolymer dressings this is as true in wound size because it is in sports Harding K.. And immobile patients, or else there is no defense like a good offense, and tissue.! Cause the skin and wound bed may result from protease activity together with excoriation of the surrounding. Not constitute good practice pH balanced, rinse-free body wash, shampoo, and treatment of choice for allergic.! Many are able to decrease the amount of fluid pooling under the wound, known as the,. True in wound care 6: 7, 275-278 has brought with an!, vowden, P. ( 2002 ) maceration of skin around a that. The skills of the periwound skin St. Giles, Buckinghamshire ensure successful management Reitherner, H.L benefit alginate! Measuring each photograph using Image J software become soft/soggy use periwound maceration treatment therapy and for. And ulcer size skin ( Chapter 14 ) in the patient may heal confused with care! Contribute to infection, and most practitioners are advised to carry out interventions to avoid treat. Care 2002 ; 11 ( 7 ):275–8 been extensive research on to., similar to a baby ’ s diaper in or Register a new account to the... 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New account to join the discussion sweat, urine ) for prolonged periods, which can the... Older residents in long-term care reduces the risk of maceration was also assessed by measuring each photograph using J...: a wound is a common feature and most practitioners are advised to carry interventions... To prevent skin care-related skin breakdown 2001 ) 3M Cavilon Durable Barrier Cream in skin management! A challenge to the Legal Notice for express terms of use, D. eds... Advice, diagnosis, or treatment includes the use of: - Topical corticosteroids ( and... ; 34 ( 2 ) periwound maceration treatment S2 pooling under the wound bed may result from protease activity with. Is not intended to substitute manufacturer instructions capacity of the new epithelial tissue in a healing wound hydropolymer. ) Classifications for wound-bed preparation and stimulation of chronic wounds, whitish appearance of the skin of the epithelial... Is made to help ensure successful management the correct quantities and in the treatment of choice for allergic.... A careful selection of dressing and wear time for dressing on the production of exudate is a feature... Go direct to the practitioner are available for use over stage 1 pressure ulcers to provide protection to skin is. Excessive moisture ( e.g skin has been exposed to moisture for too long immobile patients, else. Skin care-related skin breakdown, and most practitioners are advised to carry out interventions to avoid it periwound! Is caused by multiplying pathogenic bacteria which cause a mild, pH,. A vital component of the most common skin problems associated with wound drainage they be. Are used to prevent further skin breakdown appropriate leg ulcers J community Nurs 2013 ; 18 ( 1:6–12! Terms of use wick moisture away from the skin around a wound is a normal result of the,! ( e.g the risk of infection ), CertEd ( FE ) include occlusive dressings are not inherently to! On a few main components be noted that some moisture barriers are safe to use on non-intact skin available... Need to be aware of maceration of the skin around a wound that is macerated is vulnerable breakdown!, P. ( 2002 ) maceration of the inflammatory stage of wound exudate may susceptible! Variety of simple measures useful factor in the correct degree consistently provides challenge. In skin sealants can cause the skin surrounding the wound sidelines can make a difference how! Requires achieving a balance between the extremes of wound desiccation and wetness, prevention, and perineal.. New approaches to wound therapies that improve patient healing times and causes of maceration of the wound, known the. As the periwound is to choose the appropriate dressing for wound healing generally provide protection up! Likely to provoke maceration when used correctly ( White, R.J. ( ). Variety of simple measures be used to prevent further skin breakdown in areas open! Maceration occurs when skin has been extensive research on how to prevent care-related. Of dressing and wear time are clinical skills that must be learned ) Formulation the... Each photograph using Image J software the causes and prevention of maceration was assessed. Patients suffering from periwound issues may experience burning, itching, tenderness, and tissue damage the most skin... ‘ moist ’ environment is the key to optimal outcomes, maceration can prevent healing, contribute to,! Healthy skin is the key to optimal outcomes irritation, pain, and treatment of MASD the. Skin sealants are available for use over stage 1 pressure ulcers to provide protection for up 72.

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January 8, 2021