Changes in tissue structure and barrier function in macerated skin

Abstract

　Skin maceration is widely recognized as a main factor for incontinence associated dermatitis（IAD）and a risk factor for pressure ulcers. However, the structural and functional alterations in macerated skin have not clarified. Our recent research revealed that skin maceration induced a decreased number of cell processes in the stratum spinosum and basale, as well as a disruption of intercellular lipid structures in the stratum corneum. These structural alterations induced the transdermal penetration of huge molecules, such as dextran and albumin, into the deep layer of the dermis. According to these results, we would like to propose a new definition of skin maceration as follows, “Skin maceration is a functional disorder of the barrier for irritants and tolerance for force due to structural alterations of intercellular lipid layers and junctions between keratinocytes in the epidermis.”