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MASD Part 2: Incontinence-Associated Dermatitis and Intertriginous DermatitisA Consensus

Black, Joyce M. PhD, RN, CPSN, CWCN, FAPWCA, FAAN; Gray, Mikel PhD, CUNP, CCCN, FAANP, FAAN; Bliss, Donna Z. PhD, RN, FGSA, FAAN; Kennedy-Evans, Karen L. RN, CS, FNP; Logan, Susan BSN, RN, CWS, FACCWS; Baharestani, Mona M. PhD, APN, CWON, CWS, FAPWCA, FACCWS; Colwell, Janice C. MS, RN, CWOCN, FAAN; Goldberg, Margaret MSN, RN, CWOCN; Ratliff, Catherine R. PhD, APRN-BC, CWOCN

Journal of Wound, Ostomy and Continence Nursing: July/August 2011 - Volume 38 - Issue 4 - p 359–370
doi: 10.1097/WON.0b013e31822272d9

A consensus panel was convened to review current knowledge of moisture-associated skin damage (MASD) and to provide recommendations for prevention and management. This article provides a summary of the discussion and the recommendations in regards to 2 types of MASD: incontinence-associated dermatitis (IAD) and intertriginous dermatitis (ITD). A focused history and physical assessment are essential for diagnosing IAD or ITD and distinguishing these forms of skin damage from other types of skin damage. Panel members recommend cleansing, moisturizing, and applying a skin protectant to skin affected by IAD and to the perineal skin of persons with urinary or fecal incontinence deemed at risk for IAD. Prevention and treatment of ITD includes measures to ensure that skin folds are dry and free from friction; however, panel members do not recommend use of bed linens, paper towels, or dressings for separating skin folds. Individuals with ITD are at risk for fungal and bacterial infections and these infections should be treated appropriately; for example, candidal infections should be treated with antifungal therapies.

Joyce M. Black, PhD, RN, CPSN, CWCN, FAPWCA, FAAN, College of Nursing, University of Nebraska Medical Center, Omaha.

Mikel Gray, PhD, CUNP, CCCN, FAANP, FAAN, Department of Urology and School of Nursing, University of Virginia, Charlottesville.

Donna Z. Bliss, PhD, RN, FGSA, FAAN, School of Nursing, University of Minnesota, Minneapolis.

Karen L. Kennedy-Evans, RN, CS, FNP, KL Kennedy, LLC, Tucson, Arizona.

Susan Logan, BSN, RN, CWS, FACCWS, Kindred Healthcare, Inc., Louisville, Kentucky.

Mona M. Baharestani, PhD, APN, CWON, CWS, FAPWCA, FACCWS, James H. Quillen Veterans Affairs Medical Center, and Wound Care Program Coordinator and Clinical Associate Professor, Quillen College of Medicine, Department of Surgery, East Tennessee State University, Johnson City, Tennessee.

Janice C. Colwell, MS, RN, CWOCN, FAAN, Department of General Surgery, University of Chicago, Chicago, Illinois.

Margaret Goldberg, MSN, RN, CWOCN, Delray Wound Treatment Center, Delray Beach, Florida.

Catherine R. Ratliff, PhD, APRN-BC, CWOCN, Department of Plastic and Reconstructive Surgery and School of Nursing, University of Virginia, Charlottesville.

Correspondence: Joyce Black, PhD, RN, CPSN, CWCN, FAPWCA, FAAN, College of Nursing 985330 Nebraska Medical Center, University of Nebraska Medical Center, Omaha, NE 68198 (

Copyright © 2011 by the Wound, Ostomy and Continence Nurses Society