Scottish excoriation & moisture related skin damage tool | Right Decisions

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Scottish excoriation & moisture related skin damage tool

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Skin damage due to problems with moisture can present in a number of different ways. This tool aims to help you identify the cause to aid in decision making for treatments.

Moisture may be present on the skin due to incontinence (urinary and faecal), perspiration, wound exudate or other body fluids e.g. lochia, amniotic fluid.

Lesions caused by moisture alone should not be classified as pressure ulcers.

Combination lesions

These are lesions where a combination of pressure and moisture contribute to the tissue breakdown. They still need to be graded as pressure damage but awareness of other causes and treatments is needed.

See Pressure Ulcer Grading Tool.

Incontinence Related Dermatitis (IRD)

Mild

Erythema (redness) of skin only. No broken areas present.

Moderate

Erythema (redness), with less than 50% broken skin. Oozing and/or bleeding may be present.

Severe

Erythema (redness), with more than 50% broken skin. Oozing and/or bleeding may be present.

Treatment

Prevention/Mild IRD

Cleanse skin e.g. foam cleanser or pH balanced product. Apply Moisturiser +/or skin protectant e.g. barrier cream/film which does not affect absorbency of continence products.

Moderate-Severe IRD

Cleanse skin e.g. foam cleanser or pH balanced product. Apply liquid/spray skin protectant, OR barrier preparation, if no improvement refer to local guidelines or seek specialist advice.

NB: Observe for signs of skin infection, e.g. candidiasis, and treat accordingly (do not use barrier films as this will reduce effectiveness of treatment).

Moisture lesions: Skin damage due to exposure to urine, faeces or other body fluids

Location

Located in peri-anal, gluteal, cleft, groin or buttock area
Not usually over a bony prominence

Shape

Diffuse often multiple lesions
May be ‘copy’, ‘mirror’ or ’kissing’ lesion on adjacent buttock or anal-cleft
Linear

Edges

Diffuse irregular edges

Necrosis

No necrosis or slough
May develop slough if infection present

Depth

Superficial partial thickness skin loss
Can enlarge or deepen if infection present

Colour

Colour of redness may not be uniform
May have pink or white surrounding skin (maceration)
Peri-anal redness may be present

Last reviewed: 30/09/2020

Next review date: 30/09/2023

Author(s): Healthcare Improvement Scotland.