• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Course Login
  • Register

WoundEducators.com | Online Wound Care Certification Courses

Your online source for wound care certification.

  • Courses
  • About Us
    • Risk-Free Guarantee
    • Accredited Wound Care Course Info
    • Student Testimonials
    • Our Mission to Help
  • Why Certify?
    • What’s Included
    • How Hard is Wound Care Certification?
    • Wound Care Certification Cost
    • Wound Care Certification for Nurses
    • Getting Started: Wound Care Certification
  • Resources
    • Sign up for Our Newsletter
    • Search Wound Care Jobs
    • Post a Wound Care Job
    • Submit Your Resume
    • I Completed My Wound Care Course – Now What?
    • Wound Care Recertification Process
  • Certifications
    • Compare Wound Care Certification Options
    • ABWM® Wound Care Certifications
      • The CWS® Certification
      • The CWCA® Certification
      • The CWSP® Wound Care Certification
    • The WCC® Certification
    • The AWCC® Wound Care Certification
    • The CWCN® Certification
  • Blog
  • FAQ’s
  • Contact

Skin and Periwound Care- Part 2

May 11, 2015 2 Comments

59
SHARES
ShareTweetGoogle +Linkedin
PinterestRedditTumblrStumbleuponDiggDelicious

periwound barrierIn part 1, we discussed the risk factors contributing to periwound breakdown. Now let’s turn our attention to prevention.

Prevention of Periwound Damage

There are five keys to preventing periwound damage. These are:

  • Identifying patients at high risk for periwound skin damage (discussed in part 1 https://woundeducators.com/periwound-care/)
  • Minimizing contact of the periwound skin with wound drainage (exudate)
  • Using an appropriate barrier to protect periwound skin
  • Using dressings that will not cause trauma to the vulnerable periwound skin on removal
  • Treating any underlying pathology

Minimizing contact of the periwound skin with wound drainage (exudate)

One way to minimize contact with wound drainage and prevent maceration of the periwound is to choose the appropriate dressing for wound conditions. This can be a tricky balance between maintaining just the right amount of moisture in the wound bed- too dry and the wound bed becomes desiccated, too wet and maceration soon follows. Fortunately, modern dressing are far superior to dressings of old and offer superb absorption and adhesive properties, which means that maceration and skin trauma due to dressing removal are far less common than they once were.

Using an appropriate barrier to protect periwound skin

There are several barriers available that can effectively protect vulnerable periwound skin. Some of these include:

  • Zinc oxide- zinc oxide pastes and creams can be applied to the periwound area to form a protective barrier; a disadvantage is that they can be messy and difficult to remove
  • Acrylate sprays- these sprays provide a barrier that is easy to apply and does not need to be removed; an advantage is that it is easier to apply a dressing over this type of barrier, as opposed to a paste or cream.
  • Hydrocolloid dressings- if the periwound is already damaged, a hydrocolloid dressing can be applied to the periwound skin, while a different type of dressing is applied to the wound itself; however, there is a risk of formation of hypergranulation tissue under the hydrocolloid dressing when these dressings are used long-term
  • Reducing MMPs- pH buffers and protease modulators can be used to reduce protease activity in wound exudate, which can lead to skin damage; keeping the pH of the wound between 4.5 and 6 will keep protease activity at an acceptable level
  • Removal of biofilms- biofilms on the surface of the wound can lead to elevated levels of MMPs in wound fluid, which can in turn lead to breakdown of the periwound skin; debridement and application of a surface antibacterial agent can remove biofilm and prevent them from returning

Using dressings that will not cause trauma to the vulnerable periwound skin on removal

Skin stripping caused by dressing removal and wound adhesives can cause inflammation, swelling and pain, which can negatively impact wound healing, as well as decreasing patients’ quality of life. Using dressings with soft silicones can help reduce the risk of skin stripping. At every dressing change, the periwound should be assessed carefully for signs of damage.

Treating underlying pathology

Bacterial infections, fungal infections, contact dermatitis and other skin conditions can lead to breakdown of the periwound. Being alert for signs of underlying pathology is important in preventing periwound damage, and can also be important in identifying causation in wounds that have failed to progress in healing.

The periwound is vulnerable to breakdown and should be zealously protected. Failure to protect the periwound can lead to an increase in wound size, increased pain and failure to heal.

If you enjoyed this article, you may consider becoming certified as a wound care professional. Wound Educators is the premier online wound education site, preparing professionals to become nationally certified. If you would like to learn more about becoming a certified wound care professional, please contact us.

Sources:

Moisture-Associated Skin Damage (MASD). Wound Source. http://www.woundsource.com/patientcondition/moisture-associated-skin-damage-masd

Lawton, S. & Langoen, A. (2009). Assessing and managing vulnerable periwound skin. World Wide Wounds. http://www.worldwidewounds.com/2009/October/Lawton-Langoen/vulnerable-skin-2.html

Categories: Wound Types

About the Author

Laurie Swezey's avatar

Laurie Swezey, founder and president of WoundEducators.com, has been a Registered Nurse for more than a quarter century, with most of those years dedicated to wound treatment. Ms. Swezey is a Certified Wound Care Nurse and a Certified Wound Specialist.

Reader Interactions

Comments

  1. Taryn says

    May 11, 2015 at 11:00 am

    Hi Laura I have a sacral wound that’s healing and no drainage I’m the treatment nurse at my new job and the lady that trained me stated they use mesalt on the wound bed. I looked up mesalt and that was used for heavy drainage. What do you suggest the wound is 2.0×0.5×0.0cm

    Reply
    • Laurie Swezey says

      July 22, 2017 at 9:16 am

      I recommend finding a certified wound care nurse in your area. You can find a wound specialist here: https://portal.abwmcertified.org/ABWMweb/Directory/ABWMcontent/Directory.aspx

      Reply

Leave a Comment Cancel

This site uses Akismet to reduce spam. Learn how your comment data is processed.

sidebar

Blog Sidebar

Free Preview!

Sign up for our newsletter and enjoy a Free Preview of our Wound Care Certification Course!

Support Our “Where There’s a Wound, There’s a Way!™” Foundation

fundraiser logo

Join our “Where There’s a Wound, There’s a Way!™” fundraising campaign  Learn more

Payment Information

All major credit cards & PayPal accepted. All transactions are performed via a SSL secure server to ensure your privacy.

payments accepted visa mastercard amex discover paypal

Copyright © 2009-2018 | WoundEducators.com | All Rights Reserved
Wound Care Certification Courses Risk Free Guarantee | Terms and Policies | Sitemap

We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. By clicking “Accept”, you consent to the use of ALL the cookies.
Cookie settingsACCEPT
Manage consent

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.
Necessary
Always Enabled

Necessary cookies are absolutely essential for the website to function properly. These cookies ensure basic functionalities and security features of the website, anonymously.

CookieDurationDescription
cookielawinfo-checbox-analytics11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checbox-functional11 monthsThe cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checbox-others11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-necessary11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-performance11 monthsThis cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
viewed_cookie_policy11 monthsThe cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.

Functional

Functional cookies help to perform certain functionalities like sharing the content of the website on social media platforms, collect feedbacks, and other third-party features.

Performance

Performance cookies are used to understand and analyze the key performance indexes of the website which helps in delivering a better user experience for the visitors.

Analytics

Analytical cookies are used to understand how visitors interact with the website. These cookies help provide information on metrics the number of visitors, bounce rate, traffic source, etc.

Advertisement

Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. These cookies track visitors across websites and collect information to provide customized ads.

Others

Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet.

SAVE & ACCEPT