Contact Dermatitis and Wound Management

Contact dermatitis is a major concern for health care professionals involved in wound management. The condition can have a significant impact on patients’ well-being and can lead to pain, increased risk of infection, and delayed wound healing. These issues can significantly affect both the costs of wound care and patients’ outcomes. It is critical that health care professionals make reducing the risk of contact dermatitis a top priority by using safe and gentle wound care products and following wound care best practices.

What is Contact Dermatitis?

Contact dermatitis is a skin reaction caused by exposure to an allergen or irritant. It can be divided into two categories: irritant contact dermatitis, which accounts for approximately 80% of all cases; and allergic contact dermatitis, which accounts for the remaining 20% of cases.1

Irritant Contact Dermatitis – The most common form of chemical irritation, irritant contact dermatitis, occurs when irritants such as incontinence or peristomal fluid come in contact with the skin and create a sensitivity. This can lead to reddening, itching, and pain.1 This condition is particularly common in patients with incontinence and ostomy patients. Approximately 85% of ostomy patients will experience pouch leakage at some point. This makes it extremely important that high-risk patients be regularly assessed and cleansed.1,2

Allergic Contact Dermatitis – This is the second, less common form of contact dermatitis, which often arises after the application of allergenic products, such as medical adhesives or barrier products. It can cause significant discomfort for the patient, as well as erythema, burning, and swelling. To avoid these complications, health care professionals should take a proactive approach. Potentially allergenic products should be avoided, and wounds should be regularly assessed for signs of redness or swelling.1,2

Managing Contact Dermatitis

To prevent irritant and allergic contact dermatitis and ensure optimal outcomes for patients, health care professionals should follow wound management best practices, use gentle and secure medical adhesives and regularly inspect patients for signs of dermatitis. This will help ensure that the primary causes of dermatitis are controlled and that the condition can be addressed before it becomes serious.

Regularly Inspect At-Risk Patients – One of the most important elements of managing contact dermatitis is regular evaluation. Early signs of contact dermatitis include erythema, increased skin temperature and tenderness. If a patient is exhibiting any of these symptoms, health care professionals should attempt to identify and eliminate potential causes of dermatitis.

Cleanse and Protect the Wound Area – Irritants such as incontinence and peristomal fluid are a major cause of contact dermatitis. It is important to protect the wound area from these irritants through regular cleansing and barrier products. Using a gentle cleanser such as mild soap and water or specific wound cleanser products can help remove potential irritants while barrier products can prevent irritants from damaging the skin.1,2

Choose a Secure, Gentle Medical Adhesive – Medical adhesives play a major role in the management of contact dermatitis. Excessively harsh chemicals can irritate the skin, whereas allergenic adhesives may cause allergic contact dermatitis. Insecure adhesives may allow incontinence or other fluids to enter the wound area, potentially leading to irritant contact dermatitis. It is critical that health care professionals use medical adhesives that are both secure and safe to use on the skin.

Conclusions

Contact dermatitis can be detrimental to the wound healing process. The increased pain, risk of infection, and delayed wound healing time all raise the overall costs of wound care and lower patients’ comfort. Health care professionals involved in wound care should carefully consider their options when selecting a medical adhesive and ensure that the product they use will not unnecessarily raise the risk of contact dermatitis.

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References
1. Alavi A, Sibbald RG, Ladizinski B, et al. Wound-related allergic/irritant contact dermatitis. Adv Skin Wound Care. 2016;29(6):278–86.
2. Robertson M. Peristomal complications: assessment & management. http://www.wrha.mb.ca/education/files/MaryRobertsonPeristomalComplicatio…. Accessed March 6, 2018.