THE SKIN Structure Function Care Prevention

THE SKIN Structure Function Care / Prevention

STRUCTURE The skin covers the body providing a waterproof barrier between the external environment and internal structures/organs 3 layers • The Epidermis- renews 50 -70 days • The Dermis – blood & lymph vessels, nerve endings, sweat & sebaceous glands, hair roots • Subcutaneous layer – fat varies in thickness

ASSESSMENT • Careful observation of the skin can provide clues about body temperature, hydration & general health of the person. • • Colour is normal for racial group Warm to touch Dry surface Intact surface

HYGIENE Planning is important when assisting patients to wash / bath / shower • • • All equipment ready at hand Appropriate intervention is provided Privacy & Dignity maintained Heat loss is minimized Safety is maintained.

Pressure ulcers / sores • They are an area of localised damage to the skin & underlying tissue caused by pressure, shear or friction or combination of these. • They can occur in any age group • Patient can experience distress, pain & embarrassment. • Treatment can be costly, time consuming, requiring special care ? Equipment ? Surgery

RISK FACTORS Pressure / friction on skin causing reduced blood supply to skin • Age – reduced resilience = thinning • Chronic diseases eg cardiac / respiratory / diabetes / maligency • Reduced mobility following surgery / stroke / poor level of consciousness • Poor nutrition / weight loss or obesity • Incontinence

Pressure Points • • • Sacrum / Hip-Pelvis Shoulder blades Heels / side of foot / toes Elbows / side of hand Between the knees / ankles Ear lobes

PREVENTION Good hygiene practice Improved nutrition / hydration Frequent change of position – record 2 hourly Use of equipment eg special cushion-seating, ripple / rotary mattress / water bed • Padded booties / sheepskin layer • •

TREATMENT Prevention is better than cure Report first sign of redness / break in skin Apply sterile dressing Remove pressure by changing position. Monitor size of ulcer – observe state of wound Report any sign of necrotic tissue-discolouration Antibiotics for secondary infection Surgery to remove devitalised (dead) tissue