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Summer time is intertrigo time

Where there is direct skin-to-skin contact, e.g. in skin folds or where air cannot reach the skin for other reasons, sweat cannot evaporate and the skin softens (maceration).

In this warm and humid environment, bacteria and fungi can multiply excellently, the skin eventually becomes sore and an intertrigo is formed. Intertrigo is often found in obese or heavily sweating persons. If the clothing rubs against the skin or traps moisture, this is a risk factor.

In the warm summer months an intertrigo can also occur in healthy people.

Caution: The intertrigo is often confused with a decubitus, especially in the gluteal area!

In the following we will show you some suggestions for contracture and intertrigoprophylaxis. Not only as prevention, but also as a therapeutic accompaniment for fungal treatments in combination with an antimycotic or as therapy itself, if the skin is only irritated or slightly inflamed.

For production you need

• 1 plate LIGASANO® white 59 x 49 x 2 or 1 cm
or
• 1 bandage made of LIGASANO® white 300 x 5 x 0.3 cm or 300 x 10 x 0.3 cm

The interesting case

Patient data + medical history:

13-year-old patient with brainstem tumor; condition after respiratory failure and resuscitation; necessity of permanent invasive ventilation, tracheostoma system; missing cough reflex; diaphragmatic paresis on the right side; incomplete tetraplegia. Condition after chemotherapy and skull/brain stem radiation.

Wound therapy from 05.07.2019:

Abdominal wrinkle and groin intertrigo are cleaned with the wound irrigation solution Prontosan, as wet phase compresses are used, application time 15 minutes. Then dry phase with sterile compress for five minutes. Cover the intertrigo wound with sterile LIGASANO® mini-bandage (Art. No. 15378-030, PZN 11588835), then as a secondary bandage a 5 cm wide strip of LIGASANO® white underneath, fix it at the end. (Cave: allergy to the plaster). Daily dressing change, suspected mycosis.

Fig. 1: 05.07.2019 Abdominal fold left
Fig. 2: 05.07.2019 Abdominal fold on the right, wound surfaces flat / superficial, size 3 x 2.5 cm

As pressure protection, it was recommended to position the patient urgently on LIGASANO® green.

Wound therapy from 16.07.2019:

Abdominal wrinkle and groin intertrigo are cleaned with the wound irrigation solution Prontosan, compresses are used as wet phase, application time 15 minutes. Then dry phase with sterile compress for five minutes. Cover the intertrigo wound with sterile LIGASANO® mini-bandage (Art. No. 15378-030, PZN 11588835), then as a secondary bandage a strip of the sublingual bandage LIGASANO® white (Art. No. 15573-006, PZN 02019386), fix it at the end. (Cave: allergy to the plaster). Daily dressing change.

Fig. 3: 16.07.2019 Abdominal fold left, inflammation subsided
Fig. 4: 16.07.2019 Right abdominal crease, wound area dry
Fig. 5: 19.07.2019 Abdominal fold on the left, wound area inflamed, reddened over the entire surface, bluish discolouration, itching, suspected fungal infection
Fig. 6: 19.07.2019 Abdominal fold right anal folds and inner thigh affected by fungal infection. By order of the Schwabing Children's Hospital Use of fungicide cream
Fig. 7: 19.07.2019 Covering the intertrigo wounds with LIGASANO® white sterile 10 x 10 x 1 cm, moistened with fungicide cream
Fig. 8: 19.07.2019 Secondary dressing with 10 cm wide non-sterile bandage made of LIGASANO® white
Fig. 9: 26.07.2019 Abdominal fold left, inflammation subsided, wound epithelized
Fig. 10: 26.07.2019 Right abdominal crease, superficial wounds, signs of inflammation have subsided; the wound is still covered with sterile LIGASANO® compress and bandage; treatment with fungicide cream completed
Fig. 11: 05.02.2020 Abdominal crease left, wound healed
Fig. 12: 05.02.2020 Abdominal crease on the right, wound healed; non-sterile 10 cm wide LIGASANO® bandage is applied prophylactically

Authors:
Petra Homer, ZWM Wound Manager, Sanitätshaus Rattenhuber GmbH, 85356 Freising
Triumph nursing service, 81673 Munich

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