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MASD part 2: incontinence-associated dermatitis and intertriginous dermatitis: a consensus
Joyce M Black1, Mikel Gray, Donna Z Bliss
1College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA. jblack@unmc.edu
Abstract:
A consensus panel was convened to review current knowledge of moisture-associated skin damage (MASD) and to provide recommendations for prevention and management. This article provides a summary of the discussion and the recommendations in regards to 2 types of MASD: incontinence-associated dermatitis (IAD) and intertriginous dermatitis (ITD). A focused history and physical assessment are essential for diagnosing IAD or ITD and distinguishing these forms of skin damage from other types of skin damage. Panel members recommend cleansing, moisturizing, and applying a skin protectant to skin affected by IAD and to the perineal skin of persons with urinary or fecal incontinence deemed at risk for IAD. Prevention and treatment of ITD includes measures to ensure that skin folds are dry and free from friction; however, panel members do not recommend use of bed linens, paper towels, or dressings for separating skin folds. Individuals with ITD are at risk for fungal and bacterial infections and these infections should be treated appropriately; for example, candidal infections should be treated with antifungal therapies.
Insights
This consensus panel provides guidance on preventing and managing moisture-associated skin damage (MASD), focusing on incontinence-associated dermatitis (IAD) and intertriginous dermatitis (ITD). Key recommendations include targeted skin care and maintaining dryness in skin folds.
Area of Science:
- Dermatology
- Wound Care
Background:
- Moisture-associated skin damage (MASD) encompasses conditions like incontinence-associated dermatitis (IAD) and intertriginous dermatitis (ITD).
- Accurate diagnosis through focused history and physical assessment is crucial for differentiating MASD types from other skin injuries.
Framework:
- Consensus panel reviewed current knowledge on MASD.
- Developed recommendations for prevention and management strategies.
Implementation:
- For IAD: recommend cleansing, moisturizing, and skin protectants for at-risk individuals.
- For ITD: emphasize keeping skin folds dry and free from friction; avoid using linens or dressings to separate folds.
- Treat secondary fungal or bacterial infections, such as candidiasis, with appropriate antifungal therapies.
Implications:
- Effective management of IAD and ITD can improve patient comfort and prevent complications.
- Standardized recommendations aid healthcare professionals in consistent MASD care.
- Early and accurate diagnosis prevents misidentification and ensures appropriate treatment protocols.
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