How to Care for Periwound Skin

A wound is any type of injury that punctures the skin. While taking care of a wound is important, so is caring for the skin around the wound, known as periwound skin. You might notice that this area is sensitive or that it has a red tinge, which is known as periwound erythema. 

Continue reading to learn more about periwound skin, including how to care for the periwound area and avoid complications. 

Types of Periwound Skin Damage

Periwound skin is the skin around the wound that has been affected by the wound. There’s no exact definition of the periwound area, but researchers say it extends about 1.5 inches from the wound's edges.

The periwound skin wasn’t torn open by your wound, but it’s still affected. The trauma of the wound and the ongoing work of wound healing make the periwound area especially sensitive. Because of that, it’s prone to skin damage, which can slow your wound healing. 

The periwound area is most often damaged by moisture and injuries from the wound dressing, although it can also be exposed to infection.

Moisture-Associated Skin Damage (MASD)

As wounds heal, they naturally produce wound exudate, a fluid expelled from the wound to help it stay clean and to heal. However, as the wound exudate seeps out of the wound, it can cause a rash on the periwound skin. This is known as moisture-associated skin damage. It’s characterized by a red area that may become irritated or painful.  

Wound Dressing-Related Injuries

Some wounds, especially open wounds, need to be dressed to keep them clean. Dressings often involve gauze or medical tape, which can irritate the periwound skin. They can strip away protective layers of the skin and cause repeat physical trauma if they are removed abruptly.

This is also known as medical adhesive-related skin Injury (MARSI). More than 25% of people recovering from surgery experience MARSI in their periwound area.

Wound Site Infection

If your wound becomes infected, inflammation, pain, and redness can spread into the periwound area. You may notice other changes in the periwound area, like numbness or red lines streaking away from the wound. If you suspect an infection, you should see your healthcare provider. 

Risk Factors for Periwound Injury

Anyone who has had a wound is vulnerable to a periwound skin injury. However, some people are at higher risk for it to occur, including older people and those who have:

• Skin conditions like psoriasis
• Reduced mobility
• Incontinence
• Dementia or mental health concerns
• Diabetes
• Poor nutritional habits

Certain locations—like having a wound in a skin fold or a moist area of the body—can also increase the risk for periwound skin injury.

Signs and Symptoms of Periwound Injury

After you’re injured you should evaluate not only your wound, but the area surrounding it. Take note of the appearance of the area, seeing if it is swollen, red, shiny, hard or otherwise has an irregular appearance. This will help you keep track of healing and notice any signs of infection quickly. 

Any changes to the periwound area could be signs of periwound injury. The signs and symptoms of these injuries can include:

• Wound induration (thickening and hardening of the periwound area)
• Periwound erythema (reddening of the skin)
• Increased swelling or bruising
• Red lines coming from the wound and extending through the periwound area
• Fever or feeling generally unwell

Prevention

Proper wound care that includes the periwound area can help you avoid periwound skin damage. Following these steps can also help:

• Clean the periwound area: Clean carefully around your wound and whenever you clean the actual wound.
• Minimize how often you change dressings and adhesives: Changing dressings frequently is important for wound management, but only do it as often as your healthcare provider recommends, not more. 
• Carefully remove adhesives: As you remove an adhesive, press down on the skin beneath where the adhesive was located. Ask your healthcare professional, most likely a nurse, to demonstrate the best way to remove adhesives without damaging your skin. 
• Use barrier creams: Vaseline or other barrier creams can protect your periwound skin from moisture damage. 
• Be proactive: Evaluate your periwound area each time you change your wound dressing. If you notice changes or are worried about your periwound skin, speak with your healthcare provider. 

Treatment

Treatment for periwound skin damage involves preventing further damage while also taking care of the wound. Talk to your healthcare provider about placing your bandages in different spots, or using a barrier cream that can give your periwound skin a chance to heal. Healthy periwound skin can speed up wound healing, while damaged periwound skin can slow it down. 

Summary

The periwound area extends about 1.5 inches from the edges of a wound. It includes fragile skin that has been impacted by a wound. Moisture and damage from dressings and medical adhesives can cause the periwound skin to become red, inflamed, or painful. Carefully removing adhesives and using barrier cream can help prevent this. Talk to your healthcare provider not only about caring for your wound, but for the periwound area too. 

A Word From Verywell 

Researchers and healthcare providers are learning more about the importance of caring for periwound skin. It’s becoming clear that caring for the periwound area is an important part of wound care. If you notice any changes to the periwound area, don’t hesitate to talk with your healthcare provider.