Skin Maceration Explained

Preventing Skin Maceration
Bandages often trap excess moisture next to the skin, causing maceration.
Bandages often trap excess moisture next to the skin, causing maceration.

Maceration is often considered the first sign of worse things to come. If not treated properly in elderly or immobile people, maceration may signal that pressure wounds or wounds caused by friction are imminent.

Maceration has also been linked to slower wound healing. Proper care of wounds and informed bandage application will greatly reduce maceration and prevent more serious complications.

You've already witnessed what happens to your macerated skin once you finally get out of your long soak in the bathtub. Your skin slowly but surely returns to normal without any intervention from you.

However, in some instances, this condition is harder to resolve. Maceration often occurs in elderly, bedridden people struggling with incontinence. Bedding traps moisture next to the skin, and because the person lays immobile in bed for much of the day, the skin becomes macerated and prone to bed sores and infection. Thus, moisture levels must be reduced and monitored.

If the maceration is occurring near a bandaged wound, you may need to review your bandaging tactics. Because healing wounds all ooze fluid (called exudate), the wound area may be moist. In significant wounds, the exudate may flow into the bandage faster than the bandage can allow for air to provide helpful evaporation.

In this case, maceration may accelerate and begin to cause complications. The situation may call for more frequent changing of the bandage to keep moisture to a minimum.

If the bandage covers a large portion of skin, it may also cause heat buildup, which subsequently triggers the body to try and cool itself through sweating. That sweat may also be trapped by an overly aggressive bandage. A smaller or more frequently changed bandage may help.

Reducing moisture levels also keeps bacterial colonization to a minimum. As a result, the macerated area is much less likely to develop an infection. The ultimate result is a wound that heals faster and without further skin damage.

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