Wound management items can be provided via ONPOS when a patient is receiving ongoing care from a nurse (or other member of the healthcare team) who is applying the drerssings: Overhydration of the skin, particularly the stratum corneum, can precipitate inflammation by facilitating the passage of irritants into the skin, leading to dermatitis. The exact mechanisms by which excessive moisture causes irritation are still debatable and, to date, comparatively little work has been done to explore the mechanisms involved in each type of MASD. However, histological studies have shown that moisture damage appears to be a result of the intercellular lipid ‘mortar’ of the stratum corneum and the corneocytes being disrupted and, in effect, ‘dissolving’ the physical barrier ( Warner et al, 2003). Prolonged exposure of a patient's skin to excessive moisture is a major cause of skin breakdown but is often overlooked Unfortunately, there is always the potential for some of these ingredients to cause irritation in sensitive individuals, and this should always be kept in mind, particularly if the skin irritation appears to worsen when using any preparation. Should this occur, advice should be sought from the relevant nurse specialist. Derma Protective Plus Skin Protectant management and prevention of IAD and MASD

Derma Protective Plus Skin Protectant - Coloplast Charter

The risks of moisture-associated skin damage and incontinence-associated dermatitis remain a perennial concern for people with all forms of incontinence. The pain and embarrassment of living with these conditions (not to mention their costly, time-consuming treatment at the expense of the NHS) can be avoided or mitigated by ensuring evidence-based skin management protocols, which include the application of a skin-protectant moisture barrier. Extremely dry skin may also benefit from the regular application of Derma Protective Plus as the constituents of dimeticone and polyethylene glycol 3350 also aid vital moisture retention in this indication. Derma Protective Plus has proven its effectiveness against MASD and IAD and provides a 60% cost saving to the NHSIf you have any of the following health problems, consult your doctor or pharmacist before using this product: skin cuts/infections/sores. The provision of optimal skin care is one of the most important actions that can be taken. Ideally, skin care provided to any patient with any form of MASD should be based on a structured regimen and involve the use of a gentle skin cleanser, a protectant (barrier product) and moisturiser (if indicated). The use of ordinary soap and water should be avoided as, in most cases, the pH of the soap is too alkaline and may contribute to the skin irritation ( Voegeli, 2012). Many newer cleansing products combine a cleanser with a protectant and moisturiser, and are pH balanced to help maintain the normal, slightly acidic skin pH. Tevik K, Helvik AS, Stensvik GT, Nordberg MS, Nakrem S. Tevik K, et al. BMC Health Serv Res. 2023 Oct 6;23(1):1068. doi: 10.1186/s12913-023-10088-4. BMC Health Serv Res. 2023. PMID: 37803376 Free PMC article. If your doctor has prescribed this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Moisturisers | Dermatology Handbook Moisturisers | Dermatology Handbook

Enzymes within the epidermis act on phospholipids to produce a mixture of ceramides, free fatty acids and cholesterol ( Darlenski et al, 2011), which help to regulate stratum corneum structure and function. The stratum corneum also contains a mix of substances that actively attract and hold water in the corneocytes, collectively termed natural moisturising factor. The natural moisturising factor acts by absorbing water from the atmosphere and deeper layers of the skin, enabling the outermost layers of the skin to remain hydrated, despite the drying action of the environment. By increasing intracellular water, they allow the corneocytes to retain their turgidity and shape, thus maintaining a flexible, barrier ( Voegeli, 2012). Disruption of these carefully balanced mechanisms can lead to either excessive skin dryness (xerosis) or too much water (which can predispose the skin to MASD), both of which can cause the skin barrier to fail. A 68-year-old woman attended the continence clinic for management of recurrent and refractory urinary tract infections. The patient's older husband is her sole carer and she is a wheelchair user; she uses pads to manage urine leakage. For some time, she had been complaining of burning and irritation of her perinanal skin. In attempt to manage this, she applied liberal amounts of petroleum jelly daily. The patient had also recently developed antibiotic-associated diarrhoea (since hospitalisation for treatment with antibiotics) which increased the frequency of skin wiping with dry paper. Some ways to help prevent dry skin include using lukewarm (not hot) water when bathing, taking baths/showers less often (such as every 1-2 days), keeping baths/showers short, and using a humidifier when the air is very dry. Adults and children of 10 years and over: A very small amount on the affected area, once or twice a day for a maximum of 7 days.Some products may worsen acne. If your skin is prone to acne breakouts, look for the word "non-comedogenic" (will not clog pores) on the label. Some products may stain/discolor clothing. Ask your doctor or pharmacist for more details. Ten days later, the skin had dramatically improved, with all areas of faecal ingress expelled gradually from the dermal layers by virtue of moisture retention. Inflammation had dispelled, there were only very small pink patches where the faecal indurations had been and the overall skin integrity was much improved with no further evidence of moisture lesions.

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Skin damage from IAD and MASD can be reversed with the incorporation of an effective moisture barrier into the skin care regimen More recent models of skin barrier function suggest it comprises four separate components involving different layers of the skin (surface microbiome, chemical barrier, physical barrier and immune barrier) working in harmony to maintain overall skin integrity and offer some insight into the mechanisms involved in MASD ( Eyerich et al, 2018). Introducing an effective and long-lasting moisture barrier can help prevent damage to skin vulnerable to IAD and moisture-associated skin damage (MASD) While the threats to skin integrity presented by pressure, shear and friction are well known, frequent exposure of a patient's skin to excessive moisture is often overlooked as a major cause of skin breakdown. The information in this section is from the information leaflet provided with Derma Protective Plus (Ennogen, Dartford).

At 2-week follow-up, the skin was reviewed and the inflammation previously noted had disappeared. The patient was no longer experiencing burning and itchiness as the Derma Protective Plus allowed the continence management pads to absorb more effectively. As a result, the skin's integrity and resilience improved and the risk of incidental abrasions or moisture-associated damage was minimised. Case 2. Minor/early IAD