Skin Care Prevent, protect and repair

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Prevent skin breakdown and scar formation

Clinicians play a key role in recognizing and preventing skin disorders that may adversely affect a patients quality of life. It is important to prevent skin breakdown and protect fragile or vulnerable skin against external influences. But prevention continous even after wound closure as avoiding the formation of excessive scar tissues may be essential for patient's wellbeing.

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Moisture

Overhydratation causes swelling & disruption of strateumcorneum⁽¹⁾

After exposure to excessive moisture, the skin becomes damp, soggy and clammy, its permeability can be breached and it is susceptible to physical damage from friction and shearing forces.

Alkalinity

pH of the skin increases due to urine and feces. ⁽²⁾

The increase in the normal acidic pH of the skin (4–6.8) due to the alkalinity of urine and faeces encourages bacterial colonisation.

Incontinence

29% incontinence associated dermatitis ^(3/4)

Incontinence-associated dermatitis, a clinical manifestation of moisture-associated skin damage is a common consideration in patients with fecal and/or urinary incontinence.

Scars

100 million patients develop scars⁽⁵⁾

Incontinence-associated dermatitis, a clinical manifestation of moisture-associated skin damage common consideration in patients with fecal and/or urinary incontinence.

A total of 100 million patients develop scars in the developed world alone each year as a result of 55 million elective operations and 25 million operations after trauma.

Abnormal scarring

40% to 70% hypetrophic scarring ⁽⁵⁾

Incidence rates of hypertrophic scarring vary from 40% to 70% following surgery depending on the depth of the wound.

Protecting fragile skin - an important part of the wound care protocol

How to avoid skin lesions, pressure ulcers or friction injuries protecting skin at risk.

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Skin and wound management

^References:

^{1) D Beeckman et al. Proceedings of the Global IAD Expert Panel. Incontinence associated dermatitis: moving prevention forward. Wounds International 2015. Available to download from www.woundsinternational.com}

^{2) K Ousey et al. The identification and management of moisture lesions. Wounds UK, 2012; Moisture Lesions Supplement. Wounds UK, London}

^{3) Heywood, N. Holloway, S. Risk factors for incontinence- associated dermatitis: an evidence-based review. Wounds UK 2014, Vol 10, No 4. 22-33}

^{4) Johansen, E., Bakken, L. N., Duvaland, E., Faulstich, J., Hoelstad, H. L., Moore, Z., … Beeckman, D. (2018). Incontinence-Associated Dermatitis (IAD). Journal of Wound, Ostomy and Continence Nursing, 45(6), 527–531.}

^{5) G Gauglitz et al. Hypertrophic Scarring and Keloids: Pathomechanisms and Current and Emerging Treatment Strategies. Molecular Medicine, 2011; 17(1-2):113-125}