The skin is the human body's largest organ. Its basic function is to provide protection from external impact factors as well as prevention from trans-epidermal water loss by maintaining a barrier between the body's inner and outer. However, in the treatment of patients with exuding wounds and incontinent patients further threats are numerous. They rise significantly with the patient's age, as elderly skin is more fragile and more susceptable to disease or damage.
Major factors impacting skin at risk:
External
- wound exudate
- urinary or faecal incontinence
- digestive fluids
- removal of adhesive products
- shearing forces
Internal
- age
- nutrition
- dehydration
Maceration – when the skin's barrier function fails.
Maceration is a softening or over-hydration of skin tissue particularly of wound margins or peri-wound skin. It is commonly caused by excessive exposure of skin to wound exudate or other body fluids and may result in development or enlargement of a chronic wound. Maceration often precedes skin damage such as excoriation caused by shearing forces, removal of adhesive dressings or other external and internal impact factors that initially reduced the natural barrier function of the skin.
Supportive skin treatment is vital.
Both, the treatment of exuding, chronic wounds as well as the care of skin impacted by urinary incontinence or other body fluids constitute a major challenge for nurses every day. Beginning with the protection of wound margins from dressing adhesive or the protection of irritated skin through to the maintenance of intact skin – in order to avoid maceration risks or even the enlargement of a wound the skin deserves particular attention: Medical skin protection is an integral aspect of professional wound healing and incontinence care.
