Periwound skin management is just as important as wound bed preparation in wound healing. The goal of periwound management is to maintain an optimal moist wound healing environment while preventing skin breakdown and infection. Skin is more vulnerable in patients with certain comorbidities and conditions. Periwound skin breakdown is just one of the culprits that delay wound healing and increase pain. It is important to identify conditions and risk factors early in your wound assessment to help prevent any risk of wound progress declination.
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.1,2 The 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 periwound assessment is similar to the wound assessment; however, it is helpful to keep a few more key factors in mind:4
Periwound Characteristic Terms
Four Categories of Moisture-Associated Skin Damage
Any break is the skin is at risk for periwound breakdown and/or complications. Prevention, treatment with appropriate dressings, and managing the periwound regularly will ensure that wound healing progress is moving toward the goal of wound closure. Identify and treat abnormal periwound complications as indicated. There is an array of products available to bolster preventive techniques and manage the periwound and surrounding skin of wounds.
A patient’s quality of life is already compromised when a wound develops, and complications such as periwound skin damage can be avoided. As clinicians, we should take into consideration that every patient with a wound is vulnerable to further skin breakdown. We must have a clear understanding of causes, treatment, and prevention strategies for periwound skin damage. Ongoing assessment and monitoring will help in identifying skin changes and plan of care. Take into consideration a patient’s age, prior skin conditions and skin breakdown, skin allergens, and compliance with the plan of care.
1. Carver C. Is it moisture-associated skin damage or a pressure ulcer? WoundSource.com. 2015. https://www.woundsource.com/blog/it-moisture-associated-skin-damage-or-…. Accessed December 30, 2018.
2. Morgan N. Measuring wounds. Wound Care Advisor. 2012. http://woundcareadvisor.com/measuring-wounds/. Accessed December 30, 2018.
3. WoundSource Editors. The surrounding area: protecting periwound skin in chronic wounds. WoundSource.com. 2018. https://www.woundsource.com/blog/surrounding-area-protecting-periwound-…. Accessed December 30, 2018.
4. Livingston M, Wolvos T. Scottsdale Wound Management Guide. A Comprehensive Guide for the Wound Care Clinician. 2nd ed. Malvern, PA: HMP Communications ; 2015.
5. Lawton S, Langoen A. Assessing and managing vulnerable periwound skin. World Wide Wounds. 2009.http://www.worldwidewounds.com/2009/October/Lawton-Langoen/vulnerable-s…. Accessed December 30, 2018.
6. Meyers B. Wound Management: Principles and Practice. 2nd ed. Upper Saddle River, NJ: Pearson Prentice Hall; 2008:56–7.
7. Bryant R, Nix D. Acute and Chronic Wounds: Current Management Concepts. 4th ed. St. Louis, MO: Elsevier Mosby; 2011:117.
8. Cooper P. Skin care: managing the skin of incontinent patients. Wound Essentials. 2011;6:69–74.
The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, HMP Global, its affiliates, or subsidiary companies.