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product profile: Triad* and true

Jan 19

2 min read

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I've said this before, and I am about to say it again: wound care (and health in general) is about balance, having neither to much nor too little. Moisture is a perfect example. It is possible for skin to become over-hydrated, especially when moisture is trapped by occlusive layers, e.g. of bedding and absorptive products. Skin cells become swollen with water, stretching the cell membrane and making it likely to rupture. Thus, moisture per se doesn't cause typically breakdown, but it renders the skin more vulnerable to mechanical forces (e.g., friction), pathogens (e.g., yeast), and/or irritants (e.g., enzymes in stool or urine). This phenomenon is so common it has its own name and acronym: Moisture-associated skin damage (MASD).


When it comes to MASD, prevention is, of course, preferable. For instance, toileting protocols or containment devices can help protect skin from exposure to urine and stool.


Whether or not damage has yet occurred, a barrier cream or ointment can be used to strengthen the barrier of the skin which has been compromised by moisture. Dimethicone-based formulations are a popular choice for their breathability and ease of use, although they are not as protective against liquid stool. Petrolatum products have largely the same use profile, with the caveat that they should be applied in a thin layer, as excess product can then coat the brief or under-pad, making it less able to effectively wick moisture. A third popular choice is zinc oxide. The major advantage of zinc oxide is that it's very protective. However, the downside of this waterproof protection is difficulty of removal. Water is not enough to remove zinc oxide; mineral oil or cleansers with surfactant are required. Failure to appreciate this can lead to further skin damage from scrubbing. Another tricky thing about zinc-oxide is that it does not stick very well to a wet surface like moist skin.


So, when you need a more protective product that will still adhere to moist skin, what can you use? One option is to perform crusting before application of zinc oxide.


Another, one-step option is to use Triad cream. This product contains all three aforementioned skin protectants, as well as carboxymethylcellulose (CMC) to help with adherence. The result is a hydrophilic (water-loving) paste that can coat skin without the need for a secondary dressing (although it is hard to remove from cloth, so consider a secondary dressing for patients wanting to protect their clothes). It is capable of absorbing low to moderate exudate, and promotes autolytic debridement.

Triad comes in a distinctive yellow-orange tube
Triad comes in a distinctive yellow-orange tube

Triad is indicated for the local management of:

  • Pressure ulcers/injuries

  • Venous stasis ulcers

  • Dermal lesions/injuries

  • Superficial wounds and scrapes

  • First- and second-degree burns

  • Partial- and full-thickness wounds


Triad is not indicated for:

  • Third-degree burns

  • Infected wounds.

  • Wounds where debridement is not recommended or indicated (e.g., arterial wounds)


Any product comes with specific application considerations and should be selected based on the patient's skin needs and the nature of the moisture or exudate present. For prevention or treatment of MASD, options include dimethicone-based formulations for breathability or zinc oxide for robust protection, each with unique application considerations. When enhanced protection and adherence on moist and moisture-damaged skin is required, Triad cream can be a solution.


*This post is not sponsored; we just like the product!

Jan 19

2 min read

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