Skin Conditions/Skin Care

by Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP Recently, one of my awesome staff nurses coined a phrase that stuck with me—Mr. DoctoR Pressure Injury (MDRPI), also known as medical device-related pressure injury. MDRPIs are a common yet usually preventable problem. We wanted to raise awareness of MDRPIs for World Wide Pressure Injury Prevention Day in November of 2018, and one of our staff nurses was quite creative in doing so! She thought of using a doctor’s briefcase with medical devices inside, many of which can and do cause pressure injuries. Being creative and using acronyms are great ways not only to engage staff, but also to be sure that they remember the information provided to them. Additionally, hands-on props and interactive stations require engagement, which appeals to many different types of learners.

By Aletha Tippett MD Understanding Pathergy and Pyoderma Gangrenosum Pathergy is an aberration of the skin’s innate reactivity from a homeostatic reactive mode closely coupled to tissue healing to an abnormal destructive/inflammatory mode. Pathergy is not well understood and the cause is unknown. It is a diagnostic criteria for Behcet's disease and there is even a Skin Pathergy Test to help with diagnosis. Pathergy has also been reported in Sweet’s syndrome and it is a hallmark of pyoderma gangrenosum.

by the WoundSource Editors Denuded: The loss of epidermis, caused by prolonged moisture and friction.

By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS A wound that is too moist can be as detrimental to wound healing as a wound that is too dry. When a wound is too moist, the skin surrounding the wound, known as the periwound, can become macerated. Skin that is macerated is vulnerable to breakdown, leading to a possible increase in wound size.

Moisture-associated skin damage (MASD) is a common problem for wound clinicians. It connotes a spectrum of skin damage caused by inflammation and erosion (or denudation) of the epidermis resulting from prolonged exposure to various sources of moisture and potential irritants. These can include urine, stool, perspiration, wound exudates, or ostomy effluent. MASD includes several different categories: incontinence-associated dermatitis (AID), intertriginous dermatitis, periwound skin damage, and peristomal MASD. Of these categories, IAD is one of the more challenging issues for clinicians to recognize and treat. It is not uncommon for IAD to be inaccurately assessed as a stage 2 pressure injury. For the purposes of this blog, the focus is on differentiating between IAD and pressure injuries. Treatment strategies are also addressed.

By Paula Erwin-Toth MSN, RN, CWOCN, CNS, FAAN On April 26, 2017, I presented a webinar on the topic of Moisture-Associated Skin Damage (MASD) as part of WoundSource's webinar series on skin and wound related topics. MASD is a general term that encompasses a variety of skin injuries which involve excessive hydration of the skin. A strong knowledge of MASD can help clinicians in the assessment, prevention and treatment of the various types of moisture related skin injuries. During the informative presentation, I discussed such topics as:

By Margaret Heale, RN, MSc, CWOCN "Must Love Dogs (Cats, Lizards, Snakes, Birds, AND Arachnids)." This is a line that needs to be next to all job advertisements for home health care staff. You see, I am a dog lover, not because I love dogs but because I have a way of being able to adapt in order to survive. I work in home care as a clinical nurse specialist and have slowly learned to love dogs ever since I was reported to my manager for mentioning I didn't like them much. Shortly after this I was told not to visit a patient whose cat I had shooed away from my wound dressing field. While discussing this with a colleague, she told me of the bird that had landed on her head that morning just as she was probing the patient's foot wound with a Q-tip. Maybe everybody has had experiences like mine, but maybe not, so I would like to put mine to paper to entertain you in this season of good cheer.