Incontinence-Associated Dermatitis

Holly Hovan's picture
Causes of Incontinence

by Holly M. Hovan MSN, APRN, ACNS-BC, CWOCN-AP

With World Continence Week upon us, it is an appropriate time to discuss some types and causes along with treatment of urinary incontinence. Incontinence can have a significant impact on patient quality-of-life and skin health, subjects that will also be discussed.

Susan Cleveland's picture
Moisture-Associated Skin Damage Prevention

by Susan Cleveland, BSN, RN, WCC, CDP, NADONA Board Secretary

Part 2 in a two-part series looking at the basics of preventing and managing moisture-associated skin damage in the long-term care setting. For Part 1, click here.

WoundSource Practice Accelerator's picture
moisture-associated skin damage

by the WoundSource Editors

It has long been known in clinical practice that long-term exposure of the skin to moisture is harmful and can lead to extensive skin breakdown. The term moisture-associated skin damage was coined as an umbrella term to describe the spectrum of skin damage that can occur over time and under various circumstances. To have a moisture-associated skin condition, there must be moisture that comes in contact with that skin.

WoundSource Practice Accelerator's picture
incontinence-associate dermatitis prevention

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

WoundSource Practice Accelerator's picture
complications associated with MASD

by the WoundSource Editors

Best practice in skin care focuses on the prevention of skin breakdown and the treatment of persons with altered skin integrity. When we ask what causes skin damage we should consider the conditions that can harm the skin, including excessive moisture and overhydration, altered pH of the skin, the presence of fecal enzymes and pathogens, and characteristics of incontinence such as the volume and frequency of the output and whether the output is urine, feces, or both. If left untreated or not treated appropriately, moisture-associated skin damage or MASD can lead to further complications such as Candida infections, bacterial overgrowth, pressure injuries, and medical adhesive-related skin injury (MARSI). These can occur individually or overlap, which can make them even more difficult to manage. Today our focus is to discuss each of these complications of MASD in more detail and address some of the most common issues leading to their development.

WoundSource Practice Accelerator's picture
skin assessment and moisture-associated skin damage

by the WoundSource Editors

The performance of an accurate and complete skin assessment is of utmost importance to obtaining and maintaining healthy skin. Understanding the structure and function of the skin is key to the differentiation of normal from abnormal findings. Having this baseline knowledge aids in determining the patient's level of risk, how skin is damaged, the impact of moisture on the skin, the resulting type of moisture-associated skin damage (MASD), and whether current skin care protocols are effective and adequate.

Holly Hovan's picture
staff education in wound care

By Holly Hovan MSN, APRN, ACNS-BC, CWON-AP

As I am sure we are all well aware, not everyone loves wounds, ostomies, and continence as much as we do. Some nurses just do not have the passion (or desire) to perform wound care and learn about different modalities. On the other hand, some nurses are so eager to learn, obtain certification, and be the unit-based experts! In my experience, taking a hands-on approach to wound care education has been the most successful in terms of teaching wound assessment and dressing changes/techniques.

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Cheryl Carver's picture

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?