Moisture Associated Skin Damage is preventable and manageable. Good incontinence care is also an indicator of quality of care. State surveyors are now looking more closely at chronic cases of MASD. Document accordingly. Use the term “denuded” for macerated skin impairments. Do not use the term “excoriation” unless there is linear erosion present. *You have a resident with a colostomy that has partial thickness, denuded skin to the peri stomal area. You first want to remove the cause. Is the appliance fitting appropriately? Did the resident gain or lose weight? A treatment of a calcium alginate, and foam can be used to wick away the moisture.
Every Pressure Ulcer is investigated. Implementing appropriate treatments, monitoring, and documentation are evaluated. When a pressure ulcer is found, remove the cause. Friction, moisture, shearing, and pressure are included in the pressure ulcer investigation. *You have a COPD resident who needs the head of the bed up to breathe better. We know that this is an increased risk of pressure, due to shearing. Document, and tell the story. Also, educate your resident and staff.
We can distinguish Moisture Associated Skin Damage from Pressure Ulcers by basic characteristics. I always teach physicians and nurses to look at LOCATION, SHAPE, and COLOR. This will help you identify wound types more easily.
Moisture Associated Skin Damage
LOCATION: Diffusely distributed
COLOR: Pink or red
DEPTH: Partial thickness, or blistering
TISSUE: NO slough or eschar
Pressure Ulcers
LOCATION: Usually over a bony prominence, or under a medical device/including brief
COLOR: Red or bluish/purple
DEPTH: Partial or full thickness
TISSUE: With or without slough or eschar
