Macerated skin is frequently linked to improper wound care. Maceration can impede wound healing and render the skin more susceptible to infection, in addition to the pain and discomfort it produces. When skin is exposed to moisture for an extended period, maceration occurs. Skin that has been macerated appears lighter in color and wrinkled. To the touch, it may feel soft, damp, or sloppy.
What causes skin maceration?
Different sources of moisture come into contact with the skin regularly. Water and sweat, for example, are prominent sources of moisture that can wreak havoc on the skin’s appearance. Pus and other released fluids collect in the skin surrounding the wound during the healing process. Excreta may come into touch with skin in those who have incontinence.
You’ve most likely had skin maceration before. Mild maceration can be caused by soaking in a bath, wearing a bandage, or getting your feet wet when strolling in the rain. When your skin has had a chance to dry out, it usually goes gone quickly.
On the other hand, long-term moisture exposure can make it more difficult for macerated skin to heal.
Summary
It can be caused by taking a bath, wearing a bandage, or getting wet when walking in the rain. The skin around the wound collects pus and other discharged fluids.
Healing and dressing wounds
An immunological response is triggered by injuries that result in open wounds. A molecule called histamine plays a role in this response. It causes the blood arteries to dilate, allowing plasma to flow freely.
Plasma and other fluids cause the skin around the incision to expand as they accumulate. To avoid maceration and associated complications, wounds must be cleaned, dried, and treated.
Fluid production might arise when a wound becomes infected. When a wound is slow to heal or doesn’t heal at all, maceration is more prone to occur.
The following are some examples of chronic wounds that are susceptible to maceration:
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Sores on the bed: Pressure ulcers are another name for this condition.
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Ulcers in the veins: Legs are frequently affected.
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Ulcers caused by diabetes: The feet and legs are frequently affected.
Summary
Open wounds initiate an immune response. Histamine dilates the blood vessels, allowing plasma to flow easily. Wounds must be cleaned, dried, and treated to avoid maceration. It’s more likely to happen when a wound heals slowly or not at all.
Hyperhidrosis
Hyperhidrosis, a common disorder, causes excessive sweating. Sweating is required to keep the body cool. However, excessive sweating can result in minor maceration.
Hyperhidrosis is a condition that affects the underarms, palms, and soles of the feet. The most vulnerable parts of the body to maceration are the feet. This is because wearing socks and shoes makes it more difficult for them to dry. Severe maceration of the feet can develop to trench foot, a similar condition.
Hygiene
Skin maceration is more likely in those with incontinence or confined to bed for lengthy periods due to a medical condition.
Contact with urine-soaked clothing, incontinence pads, or bedsheets over an extended period can cause:
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maceration
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adult diaper rash, or incontinence dermatitis
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Infections caused by bacteria or fungi
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Maceration can also be caused by wet regions between the skin’s folds
Macerated skin can happen to everyone, regardless of their Hygiene. Mild maceration can also be caused by simply not drying your feet or hydrating them too much before putting on socks.
| Maceration | Percolation |
|---|---|
| A process of becoming softened by soaking in a liquid | A process of liquid slowly passing through a filter |
| Main purpose is to obtain softer substances in a liquid meidum | Main purpose is to extract particular substance into liquid |
| Results in liquid with waste and has to be purified further | Results in liquid that only contains desired substances dissolved in it. Hence no further purification is required |
| Takes long time | Takes less time |
| Do not require equipment | Requires equipment’s such as filter |
Skin Maceration Symptoms
Skin maceration is becoming more widespread in the medical field, owing to an older population. The following symptoms can be experienced by those who have moisture-related skin damage:
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Pain
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Tenderness in the vicinity
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A sweltering sensation
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Pruritus is a term for highly itching skin
People who have skin maceration are more likely to develop various issues in the surrounding area. Because these germs thrive in a dark, damp environment, bacterial or fungal diseases can develop in macerated skin.
On macerated skin, painful pressure ulcers, often known as bedsores, can develop. Macerated skin can also develop or promote dermatitis, which is a painful, itchy skin condition.
Other factors that may contribute to or exacerbate MASD include:
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Incontinence
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a lack of Hygiene
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Friction or pressure on the skin that causes excessive stress
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Yeast is present
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Humidity
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Skin irritants, either chemical or biological
Summary
Dermatitis, a painful and itchy skin condition, can also be exacerbated by it. Infections and a lack of cleanliness are two more variables that may contribute to or exacerbate MASD.
Incontinence and Skin Maceration
Incontinence, urinary can be a touchy subject. Because it is difficult or uncomfortable to discuss, it is unknown how many people suffer from it.
According to what we know, urinary incontinence affects 19% of women under the age of 45 and 29% of women over 80. Males aren’t as well-studied as women, but we do know that 5-15 percent of men in retirement homes suffer from it.
Skin maceration is closely linked to incontinence. Because incontinence might result in a damp environment, the skin can become macerated if left unattended for a long time.
The skin’s protective barriers are shattered when it is macerated. This makes it easier for bacterial and other illnesses to spread.
Urine is irritating to the skin, but excreta, in particular, can include bacteria that aggravate skin maceration. Maceration caused by incontinence might develop in as little as four days.
It commonly appears in the creases of the skin, the inner thighs, and the buttocks.
Summary
Incontinence affects an unknown number of people. If the skin is left neglected for an extended period, it might get macerated. This facilitates the spread of bacterial and other infections. It’s most common in the skin’s creases, inner thighs, and buttocks.
What Can Be Done to Prevent Wound Maceration?
When the wound environment is kept wet, the patient has a better outcome than when the wound environment is dry. According to studies, moist wound conditions promote faster healing, stronger wound contraction, less scarring, and lower infection rates, among other advantages. Patients frequently remark that keeping their wounds moist makes it easier to remove wound coverings.
However, if a wound becomes excessively damp, maceration can occur, preventing healing. Clinicians are thus faced with the dilemma of keeping the wound environment moist enough to promote healing while remaining dry enough to avoid maceration.
The most effective strategy to prevent wound maceration is to address the underlying issue causing the exudate to flow. Venous leg ulcers, for example, frequently have moderate to heavy drainage or high-flow exudate. Compression therapy or elevating the leg may be used to regulate the drainage and treat the underlying cause of venous leg ulcers.
After you’ve exhausted all of your treatment options, it’s time to think about the best wound dressing for preventing maceration and promoting healing. The dressing chosen should be based on the amount of exudate the wound is producing. Choose a highly absorbent dressing, such as a Hydrofiber, for a wound with a lot of exudates.
A less absorbent dressing may be acceptable for a wound with a lesser volume of exudate. The goal is for the dressing to absorb the exudate and prevent it from being absorbed by the skin around the wound without drying up wound.
It is critical to change dressings often to avoid maceration. Maceration can occur if dressings are left on for too long, mainly if the wound produces many exudates. Dressings should not be left on heavily exudative wounds for more than one day. Dressings for moderately or faintly exudative wounds may be left on for longer. If the clinician observes signs of infection, the dressings may need to be changed more frequently; if the wound is healing, the dressings may need to be changed less frequently.
Summary
Clinicians must balance the need to maintain the wound moist enough to encourage healing while remaining dry enough to avoid maceration. For a wound with a lot of exudates, use a highly absorbent dressing such a Hydrofiber. Dressings for moderately or lightly exudative wounds can be left on for a more extended period.
How is maceration treated?
Treatment for macerated skin is determined by the origin and severity of the condition. In most situations, simply exposing the affected area to air is enough to reverse the condition. More severe cases, on the other hand, almost always necessitate therapy.
Specific types of bandages and dressings are used to treat macerated skin caused by wounds, including:
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Occlusive dressings: These are wax-coated and nonabsorbent, making them airtight and impenetrable. They’re made to reduce wound pain and speed up healing by offering maximum moisture and microbial prevention.
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Dressings made of Hydrofiber: Sterile gauze pads and bandages absorb excess moisture as the body heals. Iodine is present in several Hydrofiber dressings, which minimizes the risk of maceration.
Inquire with your doctor about which bandage kind is appropriate for your wound. They can also show you how to put it on correctly and recommend how often you should change it. Additionally, your healthcare professional may prescribe topical treatments to help prevent excess moisture from forming around the area.
Summary
The illness is treated with specific bandages and dressings. Your doctor may show you how to correctly put it on and advise how frequently you should replace it. Topical therapies may also be used to assist in preventing excessive wetness.
Are there any complications?
Healthy skin serves as a barrier to protect internal organs and tissues from external dangers. Skin that has been macerated is a porous barrier. It is more prone to bacterial and fungal infections than normal skin.
It’s also simple to dismantle. Macerated skin around a wound can significantly lengthen the time it takes to recover.
Macerated skin can cause pain and irritation, in addition to raising your risk of infection. Rubbing macerated skin against clothing or footwear can result in a new wound or even the exposure of tissues beneath the surface.
Suffering from macerated skin
Mild skin maceration usually goes away on its own after the afflicted area dries down. People who have incontinence or who are confined to bed for lengthy periods due to a condition, on the other hand, are at a higher risk of consequences, such as infection.
Contact your healthcare professional if a wound does not appear to be healing. To avoid maceration or infection, you may require different therapy.
Frequently Asked Questions
Following are some frequently asked questions related to macerated skin.
1. Is it bad to have macerated skin?
Maceration of left-untreated wounds can obstruct healing, contribute to bacterial or fungal infection, and create discomfort or pain. Wound maceration can also cause tissue damage and necrosis, as well as high-grade dermatitis and wet eczema.
2. Is it necessary for a healed wound to be white?
When a scrape removes the layers of skin, new skin forms on the wound’s margins, and the wound heals from the edges to the center. At first, this type of scrape appears white, and fat cells may be seen. It takes longer for this type of scrape to heal.
3. In a deep cut, what is the whitish substance?
The body will repair broken blood vessels and build new tissue during the next three weeks. Collagen, which is firm, white fibers that form the foundation for new tissue, is created by red blood cells. New tissue, known as granulation tissue, begins to fill in the wound.
4. What is the best way to treat skin maceration?
In most situations, simply exposing the affected area to air is enough to reverse the condition. More severe cases, on the other hand, almost always necessitate therapy. Specific bandages and dressings, such as occlusive dressings, are used to treat macerated skin caused by wounds.
5. How do you reduce maceration?
Hydrofibre or alginate dressings can be used to cover the peri-ulcer area generously to avoid or reduce maceration, and absorbent pads can be used as a secondary dressing to offer further absorption.
6. What is the appearance of Eschar tissue?
Dark, crusty tissue at the bottom or top of a wound is referred to as eschar. The tissue looks a lot like steel wool that has been applied to the wound. The wound may appear crusty or leathery and be tan, brown, or black.
7. What causes the skin to turn white when it is wrapped in a bandage?
Excessive volumes of fluid remaining in contact with the skin or the surface of a wound for an extended period causes maceration. When a bandage is applied to anything from a paper cut on the finger to much larger wounds that require professional treatment, maceration is common.
8. How do you know whether a wound is burning?
Your wound will often feel the heat at the start of the healing process. Because white blood cells are battling germs or bacteria, this is the case. However, if the injury is heated after the first five days, it could indicate that your body is fighting bacteria and infection.
9. What is Sanguineous fluid, and what is it used for?
Sanguineous drainage is the initial type of discharge produced by a wound. When an accident occurs, it is the fresh red blood that pours out of the wound. As the blood begins to clot, it will thicken. When a wound is in the first stage of healing, known as the inflammatory stage, this initial drainage occurs.
10. What is the maceration method?
Maceration is an extraction method that takes place at room temperature. It involves immersing a plant in a liquid (water, oil, alcohol, etc.) for a varied amount of time, depending on the plant material and liquid employed. Depending on the product, the plant material might be used fresh or dried.
Conclusion
If you’re healthy and your skin is in good shape, skin maceration is rarely a problem. Follow the basic first aid rules if you have a cut or burn, making sure the wound does not become unclean or too moist.
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