Moisture-Associated Skin Damage

Moisture-associated skin damage (MASD) is inflammation or erosion caused by prolonged contact with moisture. Sources include urine, stool, perspiration, wound exudate, stomal effluent, mucus and saliva. Moisture overhydrates the stratum corneum, raises surface pH and weakens the barrier. Friction, shear and chemical irritants can then produce further injury. The result may be pain, burning, pruritus, maceration and loss of skin integrity. The central nursing question is not simply whether skin is red. Determine which fluid is contacting the skin, where it travels, whether the epidermis is intact, and whether pressure, friction, infection or another dermatitis could also be present. The first priority is to stop or contain the moisture source while protecting the skin. MASD and pressure injury may coexist, so prevention for one must not delay assessment and prevention of the other. A practical sequence is assess, cleanse gently, dry without rubbing, protect the skin, manage the moisture source, document, and reassess. Do not label MASD as a pressure injury, prescribe treatment, or start an antimicrobial independently. An RPN implements authorized care within provincial legislation, employer policy, personal competence...