Moisture-Associated Skin Damage

When the skin is damaged, it heals in a specific sequence from the edges in to the center. When the skin around the wound is wet or moist, the wound may not heal properly.
In addition, moisture itself can cause damage to the skin by attracting microorganisms like bacteria or mold and increasing the effects of friction in the affected area. Moisture-related skin damage, or MASD, is often a cause of poor healing in chronic wounds even when other treatments are optimal.

What is MASD?

MASD is a general term for the physical effects of inflammation and irritation caused by moisture around an open sore or wound. MASD involves both the presence of moisture and an additional agent such as biological, chemical, or mechanical factors. Sometimes the moisture itself may be the irritant, or it may be responsible for transporting the irritating agent to the wound.
Common sources of moisture in or near a wound may include:
  • Urine
  • Sweat
  • Feces
  • Mucus
  • Saliva
  • Wound fluid such as serum, blood, pus, or lymph
Liquid involved in cleaning the wound that becomes trapped in bandages may also cause MASD if caregivers are not conscientious about keeping dressings dry and clean.

Types of MASD

Unbroken skin regulates the body’s water content by keeping excess water out and allowing unneeded water to escape through sweat and other secretions. Excessive moisture trapped against the skin upsets the balance and creates conditions where the skin is damaged and a greater imbalance occurs.
When wounds heal, they produce secretions in the form of serum, enzymes, and waste products. If the wounds are not cleaned and dressed properly, these secretions (“exudate”) can damage the skin around the wound and cause further skin breakdown. Bandages which are not clean and dry can damage the edges of the wound, making the skin damage worse.
A stoma is an opening in the skin created for a tube to pass from the outside to the inside of the body. Examples include tracheal stomas, colostomies, and insulin pumps. These openings can become chronic wounds unless they are kept scrupulously clean and dry. There must be an appropriate sterile barrier around the opening to keep it moisture-free to prevent secretions from eroding the stoma.
Urine and feces are both very corrosive and irritating to the skin. Patients who are incontinent suffer recurrent and long-term contact with these substances and develop irritated skin as a result. The same areas (the buttocks and lower back) are also at high risk for pressure injuries, leading to moisture-related wounds.
This type of moisture-related dermatitis occurs when sweat and other secretions are trapped within skin folds. Poor circulation, friction, and lack of evaporation leads to skin damage. The location of the damage makes the area prone to bacterial infection and ulceration.
Other types of MASD may be seen in patients with long-bone fractures who are wearing casts and get water or other liquid under the cast, and individuals whose jobs require them to spend long periods in damp or wet conditions, such as sewer workers.

Treatment of MASD

The overall treatment for any moisture-related skin wound is to remove the cause of the excess moisture. Debridement of the dead tissue to reduce excess secretions may be necessary, and skin barriers around the wound if necessary to prevent moisture from entering the area.
MASD can be due to a variety of causes, and needs a wide range of cures. Remedium has a full system of products to address the types of moisture that can affect and cause wounds, and our experts will be glad to help you find the right one for your patients’ specific needs.

Moisture-wicking sheets keep bedridden patients dry and prevent damp fabric from bunching up in joints and crevices. The fabric is similar to the type used by hikers to keep sweat away from their bodies, but is softer and customizable to bedding, pillowcases, and sheets. These sheets can be used with an anti-fungal wipe to improve their benefits.

Skin protectants and barrier films are useful for the edges of wounds and stomas. Any break in the epidermis can cause a route for bacteria to the dermal layer, and allow moisture to break down the edges of the wound. Liquid skin protectant, similar to liquid bandages and sutures, creates a temporary but waterproof barrier at the edges of the skin. Films have long been used to protect permanent openings for breathing tubes, insulin pumps, and catheters.

Underpads and adult briefs. Incontinence is a leading cause of moisture-related bedsores among the elderly and individuals in wheelchairs. Maintaining a dry layer next to the skin is the best way to avoid irritating the skin, especially near the genitals and the crevices near the buttocks and lower back.

A complete skincare system of products for treatment of dry, fragile, or damaged skin is essential for those in poor health or with other risk factors for pressure sores or MASD. Remedium offers a complete range of skincare products that adhere to current best practices to manage and treat MASD and other serious skin disorders.