Interventions to avoid maceration of the skin and wound bed.

In the course of managing exuding wounds, particularly chronic wounds, failure to deal adequately with exudate can lead to exposure of the peri-wound skin to exudate and hence damage. This results in maceration of the skin and wound bed. Maceration is a largely under-recognized problem and one of the causes of delayed wound healing. Previous articles have focused on the nature and causes of maceration. This article describes a wide variety of wounds and skin conditions in which maceration might be present, or develop, during treatment, together with some strategies for avoiding maceration and the evidence base supporting them. It is only by becoming familiar with the various presentations of maceration, and with prophylactic treatment measures, that practitioners can avoid the increased costs and morbidity associated with it.