Skin maceration is the breakdown and softening of skin due to a lengthy contact with wetness. Any kind of moisture can lead to this condition: fluids from wounds, water, urine and sweat will cause the skin tissues to breakdown once in contact for a long time. In this process, the skin will become soft, wrinkle and start turning white as it separates and breaks down. All of these skin alterations will not be noticed right away, since in the early stages they may not be quite painful.
Damp skin is more susceptible to breakdown, particularly when experiencing body motion or bearing weight. The macerated skin can very readily be infected with fungi and bacteria. At times, this macerated skin leads to soreness and pain and reveals the underlying tissue layers. This skin condition is also linked to wounds, more so the wound dressings which are not changed often enough.
Causes of Skin Maceration
Some of the causes of maceration are urinary incontinence, sweating, soaking in tubs, but in most cases, it is as a result of fluids produced by wounds. The wounds produce fluids which are supposed to make the healing process faster, but in the event the wound is not well cared for, this fluid accumulation can cause the skin around the wound to deteriorate. This will happen when one wraps a bandage too tightly round the wound and when the bandage is not replaced as often as it should.
Macerated skin is mostly a side effect of varied chronic wounds like fungal lesions, bedsores, leg ulcers and diabetic foot ulcers. The fluids that emanate from these wounds normally have proteases; enzymes responsible for breaking down proteins. What this means is that proteases breaks down all skin tissues including the healthy ones.
Treatment and Prevention of Macerated Skin
There are two distinct kinds of wound dressings used in preventing and treating macerated skin: Hydrofibers and occlusive dressings. The hydrofiber dressing, similar to the sterile gauze pads, promotes healing and absorbs moisture. The occlusive dressing on the other hand is a covering that is wax coated that offers a watertight and airtight seal. There are those gauze pads in hydrofibers that have iodine, which further hinders maceration.
The most important thing is discerning the kind of dressing to go for, the right methods of putting it on, and the right time to replace it. You will only be able to get answers to the aforementioned if you talk to the physician. For instance, the gauze pad is incapable of absorbing so much fluid, thus it is vital to have it replaced and discarded after some hours. Otherwise, fluids will build up and lead to maceration. Maceration will also be imminent when the dressing used is applied very tightly.
Minor scrapes and cuts can easily be treated at home, but the lager lesions and lacerations that produce some fluid must be checked by a medical practitioner. Bear in mind that skin maceration increases the risk of infections and can greatly slow down the healing process. It is therefore paramount to consult a doctor immediately you note the signs of this condition.
Any method of treatment used must center on the source of body fluids exposure or the extra moisture. In case the exposure is as a result of urinary incontinence, the treatment should entail improving the bladder and bowel functionality, or incorporate mechanical techniques like using catheters.
Making use of fistula drainage bags or using negative pressure on wounds will aid in channeling the wound fluids from the wound surrounding. The wound exudate will also be reduced when the infection is treated. If the root cause of moisture is capillary and venous congestion, compression will be needed to ease the damage.
Zinc paste and oil based creams are efficient in guarding the epidermis from over hydration. Caution has to be taken since it may upset the application of adhesive dressing as well as interfere with the absorptive qualities of continence products and foams. The creams can be replaced using liquid film dressing, whereby the solvent will evaporate and leave a polymer film. This is a more reliable procedure rather than using solvents containing alcohol.
Maceration of skin is because of excess moisture that stays for a long span of time. It is vital for steps to be taken to reduce wetness and moisture in the wound area. The old bandage should be removed since it will have soaked moisture from perspiration. The area should then be cleaned using sterile water and kept dry. The dead skin should later on be removed to make way for growth of new healthy skin round the wound.
After the wound is totally dry, some small quantity of antibacterial ointment should be applied and the wound covered with sterile gauze. The gauze used must be able to allow free air circulation. This permits the wound to stay dry and therefore lead to less maceration. The wound should be checked each six hours and the gauge changed when moist or soaked. This will help the skin in the area surrounding the wound to stay dry.
Macerated Skin – Pictures
