Skin and Wound Care Product Ingredients: A Primer for Clinical Practice

DMCA.com Protection Status

By Kathi Thimsen RN, MSN, WOCN

Oliver S. is a resident in a nursing home. You have consulted on his case for management of perineal excoriation and rash. Your orders included the use of a cleanser and a skin protectant (both products are on the facility formulary).
Upon implementation of your orders, the resident complains of severe burning immediately following the application of the cleansing product. Rinsing relieves the complaint but immediately after the protectant is applied, the resident cries out with pain.

Repeated applications of the products result in the resident having persistent complaints of pain and burning. The skin after the fourth application is warm to touch and indurated at the excoriated edge margin and the patient is refusing use of the products.
The facility calls you and reports the situation. Your response should immediately ask:

  1. What products were used on the patient?
  2. What are the ingredients in the products?
  3. Does the patient have known allergies to any of the product ingredients?

The next steps of care should address the reduction and elimination of the product residual on the skin, as well as decisions on appropriate treatment to reduce pain, reduce the potential of additional trauma to the resident and skin, and promote the healing of the skin injury.

Ingredient implications to practice

Compromised individuals are the population that is most prevalent in care settings. Persons may have existing allergies or sensitivities to products, drugs and ingredients. Yet, in skin and wound care practice the aspect of care related to sensitivities or allergies is not always addressed or known.

Complicating patient management of altered or injured skin is the potential of product formulation (ingredient) penetration and absorption through the skin, altered skin or mucous membrane. Chemicals absorbed by the skin increase the potential for allergic reactions and systemic complications.

Cases of skin and wound products implicated in neglect, abuse, and malpractice (not to mention product liability) are shown to have been preventable. Having knowledge of a product, ingredients, and the penetration and absorption potential will serve a clinician well in providing appropriate and safe practice.

Skin and wound care products may or may not be over the counter (OTC) drugs or medical devices. Some are categorized as cosmetics. Some are even mislabeled and therefore misleading. Do you know the difference? Many products are manufactured outside of the United States and do not require the scrutiny of Food and Drug Administration (FDA) regulations. Recent headlines have included drug production of low quality, less potency, or dangerously high concentration of ingredient components. Being an informed clinician and consumer increases the potential for quality outcomes of care.

This series of ingredient related blogs will discuss the role of ingredients, what the clinician needs to know, how to decipher a label or ingredient listing and support your clinical recommendations.

About The Author
Kathi Thimsen RN, MSN, WOCN is a leader in the field of wound and ostomy care, publishing articles, presenting at conferences nationally and internationally, and serving on numerous committees and education boards including the International Association of Forensic Nurses Ethic Committee.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies.

Recommended for You

  • February 28th, 2019

    by the WoundSource Editors

    The skin is the largest organ of our body, covering 18 square feet and weighing approximately 12 pounds. Despite positive characteristics, the skin is always susceptible to and at risk of injury and breakdown. Maintaining skin integrity equals...

  • Neonatal skin
    April 26th, 2019

    By Hy-Tape International, Inc.

    Infants pose a major challenge for wound care professionals. Because neonatal skin is immature and thin compared with adult skin, it is more easily damaged and requires greater care. This makes it critical that health care professionals follow...

  • Age and Pressure Injury
    March 19th, 2019

    By Ivy Razmus, RN, PhD, CWOCN

    The very old and the very young are more alike than you might think when you consider risk for skin injuries. They are alike regarding their limited sensory perception, mobility, and activity. They are also alike in their potential for inadequate...

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. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The content is not intended to substitute manufacturer instructions. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or product usage. Refer to the Legal Notice for express terms of use.