MASD vs stage II....

[pookie6669]

Hi! I have recently returned to hands on wound care after a 6-7 year hiatus. It's amazing how many things have changed in those years! One "new" addition is the classification of MASD. Just wondering what characteristics you look for when decifering between the two. Sometimes, it's very easy but other times I really stuggle....I've looked on line for articles/books but haven't had much luck. Any advice would be greatly appreciated!!!

[CWONgal]

Moisture associated dermatitis can contribute to the development of pressure ulcers because it weakens the tissue. Typically the skin is very reddened and can become denuded and weepy....think bad diaper rash. Additionally, it's not uncommon to see satellite lesions because dermatitis and fungal infections tend to go hand in hand. A stage II pressure ulcer looks as though the surface of the skin (epidermis) has come off and most often it's at a bony prominence. You can get these from medical devices as well. It reminds me of skinning your knee as a kid...epidermis is gone and initially the area feels tacky from serous exudate which can later dry out. Another presentation of a stage II is a serous filled blister. Hope this helps!

[Crystal Webb]

MASD is Moisture Associated Skin DAMAGE!

[SmellTheRose94]

One thing I've learned is MASD is very very irregular in shape, a pressure injury will have more defined edges and will be over a bony prominence. Think of MASD as a skin erosion almost.. irregular shape and almost eroded or torn skin where the patient is incontinent or very moist.. this has helped me a lot but it is very tricky and takes a lot of experience because not everything is a classic presentation. 

[leonard_huh, BSN, MSN, RN, APN]

MASD will be spread and can be moisture induced on different areas such as abdominal folds, buttocks, posterior thighs, areas where incontinence can occur or if a diaper is placed, will be reddended, but blanable and spread in different forms. most likely can be fungal can clear up with barrier creams or fungal powder.

Stage 2 is mostly superficial can be a small skin tear looking wound and will be in one form and not spread in mulitple areas like a MASD type rash how others have described it up above

[CWS RN]

This is a very good question and a challenging topic for many clinicians. Masd has become a umbrella term that a lot of the nursing facilities are throwing on someone in order to avoid the pressure injury percentages in house. It is not that they do not have masd in some cases.

However, a lot of clinicians are not allowing the fact that you can have both components. You can have stage two's which are going to be symmetrical and circular and reside over a bony prominence and superimposed Periwound and distant periwound  Masd surrounding it. So I am very careful to look at the symmetry. You can have both components but again, the Symmetry is going to be what you're looking for.