Moisture-associated skin damage: an overview for community nurses.

The harmful effects of excessive moisture on the skin are well documented. Although traditionally this has been considered as being a specific problem of continence care, it is a common problem encountered in many different patient groups. As a consequence the umbrella term moisture-associated skin damage (MASD) has been introduced to describe the spectrum of damage that occurs in response to the prolonged exposure of a patient's skin to perspiration, urine, faeces or wound exudate etc. It is generally accepted that MASD consists of four distinct conditions, each having slightly different aetiologies, namely: incontinence-associated dermatitis; intertrigo; peristomal moisture-associated dermatitis; and periwound moisture-associated dermatitis. Careful assessment can help distinguish between the four and enable appropriate prevention and management interventions to be implemented. Whatever causes the excessive moisture, effective interventions should consist of the adoption of a structured skin care regime to cleanse and protect, and methods to keep the skin dry, controlling the source of the excessive moisture and treating any secondary infection.