Epidermolysis bullosa

Perilesional skin is that which is located on the edges of a wound, being a tissue that is especially vulnerable to damage. One of the main damages suffered by this skin is moisture excess, associated with the presence of exudate in the wounds. Maceration of the periwound skin can increase the size of the wound, especially when dressings and/or moisture barrier products are not used properly. The perilesional skin occupies a larger area in people with EB, since the non-injured areas are equally vulnerable to lesions due to the cutaneous fragility that characterizes the disease.

The principles of periwound skin care are:

• Cleansing and hydration of the skin. It is essential to gently cleanse the periwound skin when changing dressings to remove all traces of exudate that may be harmful to healthy skin. Likewise, it is important to keep the skin adequately hydrated with the creams or lotions indicated by the reference dermatologist so that it does not lose elasticity. The application of moisturizing products should be done on very clean and dry skin.
• Protection against moisture. An appropriate dressing should be chosen for the amount of exudate from each wound, which can absorb and maintain moisture within the dressing during the estimated time between cures. It is important to increase the frequency of dressing changes if we observe that the exudate passes through it. There are dressings that are very frequently used in patients with BE, such as polymeric membrane dressings, which may initially increase the amount of exudate and require greater care of the perilesional skin. It is also essential to apply barrier products against body fluids, which form a protective film that prevents damage associated with humidity and provides an adequate level of moisture to the skin. These barrier products must be left to dry after application and do not require subsequent rinsing. They can be applied in cream, liquid or spray format. Finally, when using them we must avoid doing it under adhesive products, because it could increase adherence to the skin.
• Protection against other risks, like sunlight.