Skin Conditions/Skin Care

By the WoundSource Editors The World Health Organization declared COVID-19 a pandemic on March 11, 2020. Whether you are a provider or a frontline health care professional, we are experiencing a worldwide increase in “unavoidable” medical device–related pressure injuries (MDRPIs) during the current COVID-19 pandemic. Health care workers are challenged with a higher risk of pressure injury development secondary to prolonged wear time of the N95 mask, face shield, and goggle personal protective equipment (PPE). The intensity of one or more factors of pressure, moisture, shear, and friction influence pressure injury risk.

B Janis E. Harrison, RN, BSN, CWOCN, CFCN My husband was insistent that I go home the first night he was on the surgical floor. He had a roommate, therefore the hospital policy forbade me to stay the night with him.

By Karen Zulkowski DNS, RN, CWS I previously discussed the need for a complete head-to-toe skin assessment. Certainly this can tell you whether or not the person is dehydrated, has open or discolored areas, and many other things about their overall health. Color, for example, can give you clues to additional problems such as vitamin and mineral deficiencies that can show on the skin.

By Hannah Fell, Digital Managing Editor The occurrence of conjoined twins isn’t common. Research about the development varies, but some sources suggest that the birth of conjoined twins can happen 1 in every 75,000 births, while others suggest every 50,000 to 200,000 births, and out of the latter number, 60% are stillbirths. Conjoined twins result from an embryo that doesn’t divide completely after day 13 of fertilization.

By Margaret Heale, RN, MSc, CWOCN So after I last wrote, I was to assist with a dressing change, as the resident is more relaxed with somebody having their focus on her and not also trying to do the procedure. I have done a million or two dressings in my time but had not seen a negative pressure wound therapy (NPWT) vacuum till I started helping out at the nursing home where my granddaughter works. I came across the treatment accidentally, very accidentally.

By Margaret Heale, RN, MSc, CWOCN Well, I was a matron such a long time ago when we still had candy stripers and you swallowed tablets or wrote on them with chalk. My granddaughter is doing some work at a local nursing home and offered to show me around. I held my breath as we entered, to assess the OOS (odor offense scale), something I learned when doing nursing home assessments way back when. A breath out and a slow even breath in through the nose and- mmm! Most unexpected, it must be almost lunchtime. Quite different from my day. Today's chat is about why.

Moisture-associated skin damage (MASD) is sometimes accompanied by serous exudate, a denuded appearance of skin, or a secondary cutaneous infection. As the most common form of MASD, incontinence-associated dermatitis (IAD) is characterized by erythema and edema of the skin’s surface. IAD is a top-down injury, often presenting with inflammation, erosion, or denudation in the setting of fecal or urinary incontinence.

by the WoundSource Editors Although clinical practice is hampered by a lack of rigorous studies, standardized terminology, or definitions of incontinence-associated skin damage, it is well known among health care providers that this damage places patients at increased risk for pressure ulcer/injury development. The worldwide challenge represented by incontinence-associated skin damage prompted the development of a global expert panel on the topic in 2014. The group, chaired by Professor Dimitri Beeckman, a leading authority on the topic, collaborated to develop international best practice guidelines for prevention and treatment of incontinence-associated dermatitis (IAD) that were published in 2015.1

Intertriginous dermatitis (ITD), also referred to as intertrigo, is an inflammatory condition that affects opposing skin surfaces and can occur anywhere on the body where two surfaces are in contact. For example, the pannus or abdominal skin folds, inner gluteal cleft, and axillae are some common anatomical locations of ITD. Intertrigo is seen across care settings and is increasingly common in patients with diabetes, patients with obesity, and patients who need assistance with hygiene or self-care activities of daily living. ITD is thought to be caused by a combination of two factors: moisture trapping or overhydration of the skin and friction between opposing skin folds (skin rubbing against skin for a prolonged period of time). ITD may manifest as a linear tear at the base of a fold or a linear open area within an area of macerated skin. Tears may result from stretching of overhydrated or moist skin during routine skin assessments or from friction with cleansing.

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC Being an independent wound care education consultant in long-term care, I get a lot of questions regarding moisture-associated skin damage (MASD). Is it MASD or a pressure ulcer? When do I change it from MASD to pressure ulcer in my documentation?