A complete external genital and perineal skin assessment addresses each of the following as indicated by the patient’s condition and orders, performed with consent, privacy, and a chaperone per policy, and compares each finding to baseline.
The perineal and genital skin — color, integrity, moisture, and any erythema, denudation, or breakdown.
Incontinence-associated dermatitis versus pressure injury — the distinguishing features (diffuse, moisture-related, in skin folds and over the buttocks versus localized over a bony prominence with the depth of a pressure injury).
Perineal and genital wounds — location, size, depth, tissue, and exudate (staging and treatment principles in Wounds).
The skin at a catheter or device entry site — the meatus and the securement area for erythema, breakdown, or trauma (catheter care and infection in Urinary/Renal).
Signs of a necrotizing infection — pain out of proportion to the exam, dusky or necrotic skin, crepitus, and systemic toxicity.
Fungal or candidal infection — the characteristic erythema with satellite lesions in moist areas.
Moisture sources — incontinence, drainage, and perspiration, and the effectiveness of the barrier and containment plan.
Hygiene and the patient’s or caregiver’s ability to perform perineal care.
The at-risk status — immobility, incontinence, and device presence that predispose to breakdown.
The response of the skin to the current barrier, offloading, and containment measures.
