The pandemic wrought havoc on nursing home wound care for most of 2020 and early 2021, according to leading suppliers. 

A number of factors — including lockdowns that hindered the provision of vital wound care therapy — served to amplify the cascading problems of moisture and pressure in impeding the healing process.

Nursing home staff weren’t spared from such COVID-19 related issues.

For starters, keeping facial skin in a moist environment (such as under mandated masks) for many hours softened skin, and reduced its ability to resist external pressure.

How serious was the threat?

“Although moisture associated skin damage (MASD) is not a direct cause of pressure injury, the presence of MASD can weaken the skin, making it more prone to the adverse effects of friction (opposing objects rubbing together) and shear (forces moving in different directions),” said Steven Antokal, director of clinical education at DermaRite Industries.

While pressure and moisture individually imposed damage to the skin, the one-two punch can have devastating consequences, said Tony Forsberg, national clinical director for Essity HMS North America. 

Ear loops and nose bands pressing into damp facial skin often left workers bruised and battered.

As painful and uncomfortable as such moisture-pressure injuries were on staff during the pandemic, the combination contributed to a host of problems for facility-bound elder residents, too.

MASD is often a telltale sign of more serious issues such as incontinence and wound drainage, leaving the skin to swell, become weakened and more vulnerable to breakdown from pressure and friction, said Antokal.

Prolonged moisture on the skin can increase the risk of pressure injuries, one of the most common skin integrity issues in long-term care.

“Much like advances in technology have improved efficiencies in other aspects of our lives, improvements in wearable disposable absorbent products improve the quality and efficiency of care,” said Forsberg. “The key is in adjusting standard practices to take advantage of modern products.”

From the July/August 2021 Issue of McKnight's Long-Term Care News