In a clinical context, ‘maceration’ is commonly used to describe changes in the appearance of the skin resulting from prolonged exposure to moisture or wound exudate. An alternative umbrella term, ‘moisture-related skin changes’, encompasses maceration but also includes other types of superficial skin damage such as intertrigo (inflammation caused by the rubbing of one area of skin on another), and the irritation or excoriation caused by irritant body fluids such as urine, wound fluid or faecal material and/or the presence of pathogenic micro-organisms, their toxins and metabolites and inflammatory cytokines.
In most instances it is likely that periwound skin damage, regardless of its primary cause, may be prevented by the adoption of simple measures including the application and frequent replacement of appropriate dressings, and the use of skin protectants or barrier creams combined with good nursing practice. These simple measures should impact favourably on the patient’s quality of life by reducing the pain and some of the inconvenience associated with a heavily exuding wound.
The best means by which the moisture content of the skin can be controlled (in the presence of a moderate-to-heavy exudating wound which has led to maceration of the surrounding skin) is by the use of an ideal dressing.
The ideal dressing or dressing system provides an environment within the wound in which the objectives of the current phase of treatment may be achieved in a timely and cost-effective manner without compromising either the patient’s safety or quality of life, or adversely affecting the integrity of the periwound skin or the final cosmetic appearance of the healed wound where this is relevant.
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