The skin and periwound skin disorders and management

  • Kevin Y Woo
  • Elizabeth A Ayello Ayello, Harris & Associates, Inc
  • R Gary Sibbald
Keywords: skin and peri-wound skin disorders


As the largest visible organ of the body, the skin serves many important functions that are sometimes undervalued. There are many threats to the skins integrity including aging, wounds, skin tears, and moisture-associated skin damage (MASD) with an aetiology of incontinence associated dermatitis (IAD), or wound exudate leading to periwound maceration. Water and moisture balance are both vital to maintaining the skins normal acid mantle and integrity. Skin that is too wet or too dry is in danger of breakdown and bacterial invasion. Clinicians need to identify the aetiology of the skin problem and then follow a corrective plan of skin protection. This can include the selection of dressings that match the level of exudate from the wound as well as changing the dressing at the right frequency, use of physical skin barriers such as zinc oxide, ointments, creams, film forming liquid barriers, adhesive dressings, and fluid managers, skin cleansers, and moisturisers. After a brief overview of some of the common periwound skin disorders, this review article provides a succinct review of management options illustrated with some clinical photos.

Author Biographies

Kevin Y Woo
Elizabeth A Ayello, Ayello, Harris & Associates, Inc
PhD, RN, ACNS-BC, ETN, FAPWCA, FAAN President, Ayello, Harris & Associates, Inc Clinical Associate Editor, Advances in Skin & Wound Care Faculty, Excelsior College, School of Nursing Executive Editor, Journal of World Council of Enterostomal Therapists (WCET) Senior Adviser, The John A. Hartford Institute for Geriatric Nursing Co-Secretary, World Union of Wound Healing Societies (WUWHS)
R Gary Sibbald
MD , FRCPC(Med)(Derm), MEd, FAPWCA