Periwound Skin Management

Introduction

Wound healing necessitates meticulous attention to the care of the skin around the wound site as well as the preparation of the wound bed itself. Skin breakdown and infection have to be prevented while maintaining an appropriate moist wound healing environment. Patients with certain co-morbidities and diseases have skin that is more susceptible to damage. The breakdown of periwound skin is just one of the factors that delay wound healing and increase pain. Prevent wound deterioration by identifying conditions and risk factors early on in your wound examination.

 

Periwound Assessment

Periwound and surrounding skin, reaching 4cm from the wound bed, should be evaluated as part of the wound examination. A thorough wound evaluation includes assessing the wound’s location, shape, color, edges, margins, periwound, and surrounding skin. Completing an assessment of the periwound is quite similar to performing an assessment of a wound. To be on the safe side, consider the following additional aspects. Wound type and infection are good indicators of periwound conditions, as are moisture balance and care plan management.

  • Periwound temperature
  • Exudate amount
  • Wound Location
  • Periwound shape 
  • Periwound color
  • Wound depth 

Efforts to Prevent Periwound Breakdown

Periwound breakdown and/or complications can occur with any skin injury. In order to ensure that the wound healing process is advancing toward the objective of wound closure, proper prevention, treatment, and management of the periwound are necessary. Abnormal wound complications should be identified and treated when necessary. Preventive measures can be supplemented by a variety of products, as can the wound’s periwound and surrounding skin management.

  • Maximize absorption by using larger foam dressings.
  • Adhesive dressings or tapes should not be reapplied or removed too frequently. As a result, the wound and/or periwound may be injured or break down.  Medical Adhesive-Related Skin Injury (MARSI), is a term used to describe an injury to the skin produced by medical adhesives.
  • In order to protect the periwound and surrounding skin, apply skin sealant dressings (liquid or spray).
  • Removing adhesive dressings the correct way is really important. This can be done most effectively by pressing down on the skin near the edge of the dressing while lifting up the adhesive.
  • Incontinence creams and ointments act as a moisture barrier to keep the skin dry.
  • Moisture balance is vital in wound healing progress.  Using the correct absorptive dressing to maintain a balance of the wound microenvironment. 

Conclusion

Preventing complications such as periwound skin damage can improve a patient’s quality of life, which has already been impacted by wounds. Patients with open wounds are at risk of skin deterioration, and practitioners must consider this when treating them. Periwound skin injury necessitates research into its causes, treatments, and prevention. Skin changes and treatment plans can be identified by regular evaluation and monitoring. Consider a patient’s age, previous skin disorders and skin breakdown, skin allergies, and adherence to their treatment plan when making a decision.

 

Disclaimer

The views and opinions stated in this blog are exclusively those of the author and do not reflect iWound, its affiliates, or partner companies.

 

Future Reading and References 

Scottsdale Wound Management Guide. A Comprehensive Guide for the Wound Care Clinician. 2nd Edition.  By Matthew Livingston, RN, BSN, CWS and Tom Wolvos, MS, MD, FACS

WoundSource blog submitted by Cheryl Carver on April 28th, 2015. Is it Moisture-Associated Skin Damage or a Pressure Ulcer?

 Meyers, B. Wound Management: Principles and Practice. 2nd ed. Upper Saddle River, NJ: Pearson Prentice Hall; 2008:56–7.

 

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