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. 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: The promotion and maintenance of skin integrity is a common challenge in all care settings and is often used as an indicator of the overall quality of nursing care provided. In simple terms, skin integrity can be defined as the skin being ‘whole, intact and undamaged’ and disruption to skin integrity can have a negative effect on patient wellbeing and quality of life ( Woo et al, 2017; Fletcher et al, 2020). Most emollients can be used safely and effectively with no side effects. However, burning, stinging, redness, or irritation may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. The information in this section is from the information leaflet provided with Derma Protective Plus (Ennogen, Dartford).

Ennogen | Wound Care Handbook Ennogen | Wound Care Handbook

It is generally agreed that urinary incontinence on its own does not necessarily lead to IAD but, when combined with faecal incontinence or the passage of liquid stool, the risk increases significantly. This is thought to be because of overhydration of the epidermis and an increase in the skin pH away from the protective slightly acidic range. The change to a more alkaline pH activates digestive enzymes present in the faeces, which then further contribute to the damage caused to the epidermis. Liquid stool tends to be richer in digestive enzymes, and this, when combined with its elevated water content, is particularly damaging to the skin ( Gray et al, 2012). Preventing and treating moisture-associated skin damage

Tell your doctor right away if you have any serious side effects, including: unusual changes in the skin (such as turning white/soft/soggy from too much wetness), signs of skin infection. 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 Derma Protective Plus is up to 60% cheaper than other leading brands, and could therefore present a significant cost saving to the NHS. Case 1. Skin vulnerable to IAD Use this medication regularly to get the most benefit from it. Most moisturizers need water to work well. Apply the product after bathing/showering while the skin is still damp. For very dry skin, your doctor may instruct you to soak the area before using the product. Long, hot, or frequent bathing/washing can worsen dry skin.

Skin protection | Wound Care Handbook Skin protection | Wound Care Handbook

In individuals assessed as being at a high risk of developing IAD, preventive measures should be instituted as soon as possible. It has been shown that IAD can occur in susceptible patients within four days of admission to a critical care unit ( Bliss et al, 2011) and more recent work by Phipps et al (2019) demonstrated changes in skin barrier function after 15 minutes' exposure to a wet incontinence pad in healthy volunteers. 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 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.Derma Protective Plus; IAD; Incontinence-associated dermatitis; MASD; Moisture-associated skin damage. 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).

Plus Skin Protective Cream | For Moisture Damage - Vyne Proshield Plus Skin Protective Cream | For Moisture Damage - Vyne

This is a medicine; Consult your doctor or pharmacist if you have an underlying medical condition, are taking any other medication or complementary therapy, or if symptoms persist. If you are using this product to help treat diaper rash, clean the diaper area well before use and allow the area to dry before applying the product. A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/ tongue/throat), severe dizziness, trouble breathing. Once saturated, wet skin is more susceptible to damage caused by friction and shearing forces, and further irritation and inflammation can occur as the normal skin flora is able to penetrate the disrupted skin barrier and activate the skin's well-developed immune defences ( Newman et al, 2007). Incontinence-associated dermatitisValls-Matarín J, Del Cotillo-Fuente M, Ribal-Prior R, Pujol-Vila M, Sandalinas-Mulero I. Valls-Matarín J, et al. Enferm Intensiva. 2017 Jan-Mar;28(1):13-20. doi: 10.1016/j.enfi.2016.11.001. Epub 2017 Jan 16. Enferm Intensiva. 2017. PMID: 28110903 English, Spanish. What practices do you use to help prevent skin damage from incontinence in the patients for whom you care? The skin barrier is further enhanced by the maintenance of an acidic surface with a pH of 4–6, termed the acid mantle. This helps to maintain a healthy balance of resident skin bacteria; it is also recognised that skin pH plays an important role in regulating skin health and stratum corneum cohesion ( Ali and Yosipovitch, 2013). For information on locally preferred dressings please refer to the Wound Management Formulary below All three cases demonstrated an improvement in the patient's skin condition after the product was introduced as part of their skin care regimen. Conclusion