Reducing Moisture-Associated Skin Damage

Intertrigo-400x300 Moisture-associated skin damage (MASD) involves skin inflammation, irritation and erosion that results from prolonged exposure to moisture from various sources including urine, stool, wound exudate, perspiration, mucus or saliva.

The four main types of MASD are:

  1. Incontinence-associated dermatitis (IAD)
  2. Intertrigo (in skin folds)
  3. Periwound (around a wound) MASD
  4. Peristomal (around a stoma) MASD

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Protecting Peristomal Skin

Ostomy+ body illustrationMore than 1 million Americans have a stoma, and it has been estimated by the United Ostomy Association of America that 130,000 ostomy surgeries are performed every year in the United States.  Unfortunately, up to 80% of people with a stoma experience peristomal skin problems. Prevention, early identification and proper care for peristomal skin complications are critical for individuals with a stoma.

Stomas can be either temporary or permanent.  A stoma is formed during a surgical procedure (ostomy) to divert the flow of urine or feces outside the body for collection in a stoma appliance or ostomy pouch system that consists of a baseplate, washer with flanges and a pouch for collecting effluent.  There are 3 main types of stoma: the colostomy, the ileostomy and the urostomy.  The reasons for ostomies include cancer involving the colon rectum or bladder, inflammatory bowel diseases such as Crohn’s disease, congenital malformations and diverticular disease.

Several studies suggest that stoma complications within the first 2 to 3 weeks following surgery are common.  85% of individuals with a stoma experience stoma leakage.  A pouch system that fits well immediately following surgery may not fit well several weeks later.  Selection of ostomy equipment that is appropriate for the type of stoma, volume and consistency of the effluent as well as self-care skill level of the individual with a stoma is critical.  Proper use of the stoma appliance including proper pouch application, timely emptying and pouch changing all contribute to helping prevent skin problems. Continue reading

The Importance of Skin Lipids

Bricks and mortarThe stratum corneum or uppermost layer of the epidermis has been described of as consisting of bricks and mortar.  Long thought of as an inactive layer of dead skin cells, in contrast, the stratum corneum is highly dynamic.  The bricks are the corneocytes or differentiated keratinocytes that are tightly connected by links called corneodesmosomes and the mortar is the extracellular space composed of highly ordered lamellar lipids that form membranes.  The lipids within the extracellular spaces help provide a barrier to moisture and electrolyte loss from the skin that is absolutely required for survival.  These lipids include ceramides, cholesterol, and fatty acids.

Viniferamine® skin and wound care products contain ingredients that protect skin lipids and enhance the barrier function of skin to help prevent excessive transepidermal water loss (eTEWL).  Oleuropein, an olive polyphenol found in Viniferamine®, has been shown to reduce TEWL indicating it’s ability to increase skin barrier function.  Evidence also indicates that melatonin, another important ingredient in Viniferamine® skin and wound care products, has a stimulatory role in building and maintaining the epidermal barrier.

The lipids that form the extracellular lamellar membranes are secreted from lamellar bodies produced by keratinocytes as they differentiate into corneocytes.  Interestingly, a calcium gradient exists within the epidermis consisting of higher levels of extracellular calcium found in the upper layers of the epidermis.  When the skin barrier is disrupted, increased water movement through the stratum corneum causes decreased calcium in lower levels that stimulates lamellar body synthesis and secretion of lipids.  This normal skin response is in place to assure that impairments in barrier function are corrected.  Continue reading

 Avoiding Hand Dermatitis

Hand dermatitis is one of the most common problems encountered in dermatology with a prevalence possibly as high as 50% hand dermatitisor greater in certain occupations. The dis­comfort associated with hand der­matitis frequently results in a de­creased quality of life. In fact, hand dermatitis can be debilitating for many years.

Dermatitis (or eczema) is inflam­mation of the skin, characterized by itchy (pruritic), red, weeping skin with vesicles and/or crusty patches. The risk factors for hand dermatitis include chemical expo­sures, frequent handwashing, and wet-work environments contribut­ing to a higher prevalence in specif­ic occupations including healthcare professionals, machinists, hair­dressers, and food industry em­ployees. Continue reading

Relief from Itching

Itching Itch or pruritus has been defined as an unpleasant sensation that elicits the desire or reflex to scratch.  Itch is the most common symptom in dermatology.  It is also the most common skin complaint in people over the age of 65 years and it can have a major impact on an individual’s quality of life.  Itch has many similarities with pain, but the responses to itch and pain differ since pain evokes a withdrawal response and itch evokes a scratch response.  We all know that the itch sensation can be reduced by the painful sensation caused by scratching.  Studies have also shown that various other types of pain stimuli can also reduce itch.  In some ways, itch and pain are regarded as closely related, however, itch and pain are different sensations that are processed by distinct sets of neurons.  Continue reading

Focusing on Diabetes

Diabetic Support Tools and FruitType 2 diabetes mellitus is the most common form of diabetes. According to the American Diabetes Association, 85% of people with type 2 diabetes are overweight or obese. Also startling, the prevalence of diagnosed diabetes in the U.S. increased by 128% from 1988 to 2008. By the year 2050, as many as 1 in 3 American adults are projected to be diabetic if the present trend continues. Continue reading