moisture associated skin damage pathway
TRANSCRIPT
Moisture Associated Skin Damage Pathway
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BiBliOgRAPhy
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Please contact your local 3M representative for further information on educating your nursing team on the MASD pathway. Alternatively, please contact us at www.cavilon.co.uk
Beeckman D, Schoonhoven l,Fletcher J, et al (2007) EPUAP classification
system for pressure ulcers: European reliability study. J AdvNurs 60(6): 682–91
Black JM, gray M, Bliss DZ, et al (2011) MASD part 2: incontinence associated dermatitis and intertriginous dermatitis: a consensus. J Wound Ost
Continence Nurs 38(4):359–70
Colwell JC, Ratliff CR, goldburg M,et al (2009) MASD part 3: perisotimal moisture-associated dermatitis and periwound moisture-associated dermatitis: a consensus. J Wound Ostomy Continence Nurse 38(5): 233-241.
Defloor T, Schoonhoven l, Fletcher J, et al (2005) Pressure Ulcer
Classification differentiation between pressure ulcers and moisture lesions.
European Pressure Ulcer Advisory Panel. Available from: http://www.epuap <http://www.epuap/> .
org/archived_reviews/EPUAP_Rev6.3.pdf
grey M, Black JM, Baharestani MM, et al (2011) Moisture associated skin damage: an overview and pathophysiology. J Wound Ostomy Continence
Nurse 38(3): 233–41
National Pressure Ulcer Advisory Panel & European Pressure Ulcer Advisory Panel (2011) Pressure ulcer prevention recommendations. in: Prevention and treatment of pressure ulcers: clinical practice guideline. 2009. NgC:008145
Rees J, Pagnamenta F (2009) Best practice guidelines for the prevention and management of incontinence-associated dermatitis. Nursing Times 105(36):24-6
Romanelli M, Vowden K, Weir D (2010). Effective exudate management made easy. Wounds international 1(2).
Voegeli D (2012) Moisture-associated skin damage: aetiology, prevention and treatment. Br J Nurs 21(9):517–21
White RJ, Cutting KD (2003) interventions to avoid maceration of the skin and wound bed. Br J Nurs 12(20): 1186-203
Produced in collaboration with Caroline Dowsett PhD, MSc, BSc (hons), Dip N, D.N, RgN Nurse Consultant in Tissue Viability
gENE
RAl
CRiT
ERiA
•Nu
tritio
nals
tatu
s•
Mob
ility
•Pr
evio
uss
kin
diso
rder
•Al
lerg
ies
•Pa
tient
bat
hing
/ski
n ca
re ro
utin
e
MAS
D SP
ECiF
iC•
Urin
eor
faec
alin
cont
inen
ce
•
Exce
ssive
sw
eatin
g
•Ex
cess
ivew
ound
exu
date
•St
oma
leak
age
iS T
hE S
KiN
DAM
AgE
CAUS
ED B
y:
Urin
e or
faec
al m
atte
r Ex
cess
ive m
oist
ure
from
sw
eatin
g
Wou
nd e
xuda
te
Stom
a le
akag
e
Excl
ude
pres
sure
dam
age
as a
cau
se (3
M D
iffer
entia
tion
guid
e*)
ASSE
SSM
ENT
DiFF
EREN
TiAl
DiA
gNO
SiS
Moi
stur
e As
soci
ated
Ski
n Da
mag
e Pa
thw
ay
MAN
AgEM
ENT
iMPl
EMEN
T SK
iN C
ARE
REgi
MEN
REAS
SESS
MEN
T &
EVAl
UATi
ON:
REC
ORD
OUT
COM
ES
SKiN
iS iN
TACT
BUT
REg
UlAR
REA
SSES
SMEN
T RE
qUiR
EDTh
ERE
iS E
ViDE
NCE
OF S
KiN
BREA
KDOW
N
iNCO
NTiN
ENCE
ASS
OCiA
TED
DERM
ATiT
iS (i
AD)
Sour
ce o
f MAS
DUr
ine
or li
quid
faec
es
Eryt
hem
a &
infla
mm
atio
n of
the
skin
, er
osio
n &
denu
datio
n ca
n oc
cur a
s re
sult
of e
xpos
ure
to u
rine
and
faec
es
iNTE
RTRi
giNO
US D
ERM
ATiT
iS
(MAS
D W
iThi
N SK
iN F
OlDS
)
Sour
ce o
f MAS
DPe
rspi
ratio
n
Mild
, mirr
or im
age
eryt
hem
a on
eac
h si
de o
f the
ski
n fo
ld. M
ay h
ave
eros
ion
& de
nuda
tion
as re
sult
of e
xpos
ure
to c
hron
ic
pers
pira
tion
PERi
WOU
ND D
ERM
ATiT
iS
Sour
ce o
f MAS
DEx
udat
e, a
dhes
ive s
tripp
ing
or in
fect
ion
Eryt
hem
a &
infla
mm
atio
n of
ski
n w
ithin
4c
m o
f wou
nd e
dge,
may
sho
w
denu
datio
n or
ero
sion
PERi
STOM
Al M
OiST
URE
ASSO
CiAT
ED D
ERM
ATiT
iS
Sour
ce o
f MAS
DUr
ine
or fa
eces
see
page
infla
mm
atio
n &
eros
ion
of s
kin
rela
ted
to
moi
stur
e fro
m s
tool
, urin
e, &
per
spira
tion,
ex
tend
ing
outw
ard
from
sto
ma
site
iNCO
NTiN
ENCE
ASS
OCiA
TED
DERM
ATiT
iS (i
AD)
•Ap
ply
barri
erfi
lmp
rodu
ct,3
M™
Ca
vilon
™ N
o St
ing
Barri
er F
ilm
or a
ski
n pr
otec
tant
•Tr
eata
reas
ofc
utan
eous
can
didi
asis
(th
rush
) with
app
ropr
iate
ant
ifung
al
treat
men
t
•Co
nsid
erth
eus
eof
app
ropr
iate
de
vices
to d
ivert
urin
e or
sto
ol
•Ke
eps
kin
clea
nan
ddr
y
iNTE
RTRi
giNO
US D
ERM
ATiT
iS
(MAS
D W
iThi
N SK
iN F
OlDS
)
•Ex
amin
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area
oft
hes
kin
fold
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incl
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se
•En
lista
ssis
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ord
erto
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tly
lift t
he fo
ld w
ithou
t cre
atin
g or
ex
acer
batin
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ctio
n an
d fis
sure
fo
rmat
ion
•Co
nsid
erti
ssue
type
and
trea
tmen
taim
w
hen
sele
ctin
g tre
atm
ent
•Av
oid
prod
ucts
con
tain
ing
chlo
rhex
idin
egl
ucon
ate,
alc
ohol
, or p
erfu
mes
as
thes
e ca
n be
abs
orbe
d by
dam
aged
sk
in
•M
easu
res
toe
nsur
eth
eco
ntin
ued
dryin
g of
the
skin
fold
mus
t be
a pr
imar
y tre
atm
ent s
trate
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otec
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cted
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afro
mfu
rther
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acer
atio
n (3
M™
Ca
vilon
™ N
o St
ing
Barri
er F
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PERi
WOU
ND D
ERM
ATiT
iS
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sed
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ceo
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udat
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(3
M E
xuda
te P
athw
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•So
me
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ess,
util
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al a
nd h
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hape
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M™
Teg
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hyd
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, Foa
m
Adhe
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orbe
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ress
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)
•Co
nsid
erth
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tent
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orw
ound
in
fect
ion
•If
the
wou
ndis
not
hea
ling
or
prog
ress
ing,
furth
er in
vest
igat
ion
may
be
requ
ired
to e
stab
lish
co-m
orbi
ditie
s
•M
anag
ene
crot
ica
nds
loug
hyti
ssue
us
ing
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sing
s w
ith a
utol
ytic
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litie
s.
This
may
be
cont
rain
dica
ted
in c
erta
in
cond
ition
s su
ch a
s di
abet
es a
nd th
ose
with
arte
rial d
isea
se
•If
bone
ise
xpos
edc
onsi
dert
heri
sk
of o
steo
mye
litis
and
refe
r to
suita
ble
heal
th c
are
prof
essi
onal
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otec
tper
iwou
nda
rea
from
furth
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brea
kdow
n an
d m
acer
atio
n (3
M™
Ca
vilon
™ N
o St
ing
Barri
er F
ilm)
PERi
STOM
Al M
OiST
URE
ASSO
CiAT
ED D
ERM
ATiT
iS
•Co
nsul
tSto
ma
Nurs
esp
ecia
listf
or
guid
ance
on
appl
ianc
es
•Pr
otec
tper
isto
mal
are
afro
mfu
rther
br
eakd
own
and
mac
erat
ion
(3M
™
Cavil
on™
No
Stin
g Ba
rrier
Film
)
Ensu
re p
atien
t con
sent
to a
ny s
kin c
are
prac
tice
and
treat
men
t•
Cont
rol s
ympt
oms
and
treat
the
unde
rlyin
g ca
use
•
Utilis
e di
spos
able
was
h ba
sins
to re
duce
cro
ss in
fect
ion ri
sk•
Mois
turis
e an
d pr
otec
t usin
g ap
prop
riate
bar
rier p
rodu
ct(s)
, eg
•3M
™ C
avilo
n™ S
kin C
are
Rang
e
Educ
ate
all c
are
prov
ider
s on
pre
ferre
d m
etho
d of
skin
car
e•
Adop
t a m
ultid
iscip
linar
y app
roac
h•
Rem
ove
irrita
nts
from
skin
and
pro
tect
from
furth
er e
xpos
ure
•
Clea
nse
skin
with
ph
neut
ral w
ipes
/clea
nser
•
Chec
k sk
in fo
lds
for r
esid
ual f
aece
s/ur
ine
•
Use
devic
es/p
rodu
cts
to w
ick m
oistu
re fr
om a
ffect
ed s
kin•
if no
impr
ovem
ent o
r det
erio
ratio
n in
con
ditio
n, re
fer t
o TV
N &/
or c
ontin
ence
CNS
incl
ude
patie
nt in
all
desc
isio
ns re
latin
g to
trea
tmen
t Co
mpl
ete
an a
sses
smen
t and
car
e pl
an in
all
inst
ance
s