Mechanical Injury

Image is from wocn.org

 

 

Patchy areas of superficial skin loss corresponding to areas of trauma

Can be full thickness skin loss

Caused by improper removal of tape or barrier

May also be caused by scrubbing or picking on skin

Abrasive cleansing techniques

Convex pouching system

Ill-fitting pouching system

Ostomy belt and rigid appliances

Reference: Emory University, 2013; WOCN, 2007

 

 

Treatment:

 

 

Eliminate causative factor.

Crusting denuded areas.

If areas ulcerated, consider use of calcium alginate, hydrofiber, or hydrocolloid dressings, before applying pouching system.

Do not use skin sealants with alcohol as they sting.

Education of patient and/or caregiver.

 

Reference: WOCN, 2007

 

Prevention:

 

Gently cleanse the skin. Avoid picking.

Gently remove pouching system. Consider use of adhesive remover.

Consider use of skin sealants under adhesives.

Avoid use of cement and strong adhesive spray.

Ensure proper fit of pouching system.

If belt used—make it snug, not tight. May have to use wider belt.

Reevaluate need for convexity.

 

Reference: Emory University, 2013; WOCN, 2007