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What is maceration?

When we sit in a bath for too long, the skin becomes white and wrinkled.  This is the same process as the maceration that is caused around wounds or over buttocks.  Generally white in appearance (Fig 1) but can develop further into red and sore excoriation (chafing, abrading or wearing off the skin (Fig 2).

It is important to control the moisture content of wounds and areas of vulnerable tissue such as the buttocks when incontinence is concerned.  

The macerated / excoriated skin should not be washed with soap as it has a drying affect and the skin needs to be kept hydrated moisturisers which trap existing moisture in the skin. Therefore, washing the skin with an emollient is advisable although this may prevent any dressing from adhering to the skin around the wound so care should be taken. 

If it is the case that a dressing is required, then wash around the wound with plain water, dry well and then apply a barrier cream or (preferably in this case) a film spray that will assist the dressing to adhere. 

Figure 1. Maceration
Figure 2. Excoriation

For more help or information on the prevention and treatment of pressure ulcers ask OSKA.