Introduction
David Voegeli argues that the protracted exposure of the human skin to wet conditions has adverse consequences within the health care context. However, this condition has been previously perceived as a specific challenge related to continence care. This condition can be observed in any situation where individual’s skin is exposed to prolonged contact with moisture. Occasionally, the terms, perineal dermatitis and incontinence-associated dermatitis (IAD), are used to refer to the skin impairment that results from those conditions. Voegeli (2012) states that these phrases describe only a single cause as there is done so little to create awareness of the general factors resulting in the impairment of the skin because of unfavorable wet conditions. They do not also make any reference to potential general approaches, which are related to any of the treatment regimes. The article aims to investigate the recent trends in this field and the impacts they have on health care.
Normal skin structure and function
The author argues that one of the main functions of skin is to safeguard the body from the external environment. The skin prohibits harmful pathogens and substances from penetrating into the body. It also serves as a significant barrier from moisture. The skin also regulates the amount of fluids that the body gains or sheds. This function is carried out by the uppermost layer referred to as the epidermis. The outermost section of the skin is particularly responsible for saving the underlying tissues from various irritants. It is known as the stratum corneum.
Moisture-associated skin damage
Voegeli (2012) holds that the damage that occurs because of the prolonged exposure of the skin to wet conditions has not been recently raised. However, the term Moisture-Associated Skin Damage (MASD) is relatively a new term in the UK. It refers to the spectrum of impairment that occurs as a result of prolonged exposures to moisture.
Types of MASD
The protracted exposure of the skin to human wastes and urine results to a condition referred to as incontinence-associated Dermatitis (IAD). Voegeli (2012) argues that 50% of all the patients in nursing homes and 35% of residents in community dwellings suffer from urinary incontinence. The rates of IAD range from 5.6% to 50%, which is even higher for patients suffering from fecal incontinence. However, there is a high probability that the incidents of IAD are miscalculated due to the lack of validated evaluation and documentation tools (Voegeli, 2012).
Peristomal moisture-associated dermatitis is described as an inflammation and impairment of the skin because of moisture. The symptoms appear in areas where the skin is folded and projected outwards within a 4-inch radius (Voegeli, 2012). When a wound is healing, it usually produces some form of secretions known as exudate. However, an increased quantity of exudate has an adverse effect on the skin. Excess moisture leads to maceration, which eventually results in the degeneration of the skin. Intertriginous dermatitis is a disease which results in inflammations. It is common in areas where the skin surfaces are overlapped. It is usually observed in the axillary and inguinal areas. In women, it commonly occurs under the breasts. However, this condition can develop in any area where the skin folds (Voegeli, 2012).
Preventing and treating moisture MASD
The primary agent that leads to the four major forms of MASD mentioned above is the exposure of the skin to wet conditions. The primary preventive measure is to restrict excessive exposure of the skin to moisture. However, this is just a single phase of prevention. It is recommendable for the health caregiver to:
- Implement a structured skin-care routine,
- Use products that absorb moisture from areas with a high potential of developing MASD,
- Manage the source of excess moisture, and
- Manage secondary infections.
Conclusion
It is widely acknowledged that MASD is comprised of four main conditions. However, they have slightly divergent etiologies, most of which have been covered in this article.
Reference
Voegeli, D. (2012). Moisture-associated skin damage: aetiology, prevention and treatment. British Journal of Nursing, 21(9), 517-521.