Functions of the Skin
Cross-Section of Normal Skin
Factors Affecting the Skin
• Unbroken and healthy skin and mucous membranes defend against harmful agents
• !esistance to in"ury is affected by age# amount of underlying tissues# and illness
• Ade$uately nourished and hydrated body cells are resistant to in"ury
• Ade$uate circulation is necessary to maintain cell life
 
Deelopmental Considerations
• In children younger than % years# the skin is thinner and &eaker than it is in adults
• An infant's skin and mucous membranes are easily in"ured and sub"ect to infection( a child's skin becomes increasingly resistant to in"ury and infection
• )he structure of the skin changes as a person ages( the maturation of epidermal cells is prolonged# leading to thin# easily damaged skin
 
Causes of Skin Alterations
• Very thin and +ery obese people are more susceptible to skin in"ury
, -luid loss during illness causes dehydration
, Skin appears loose and flabby
• E.cessi+e perspiration during illness predisposes skin to breakdo&n
• /aundice causes yello&ish# itchy skin
 
!ypes of Wounds
• Intentional or unintentional
• 1pen or closed
• Acute or chronic
 
"rinciples of Wound #ealing
• Intact skin is the first line of defense against microorganisms
• *areful hand hygiene is used in caring for a &ound
• )he body responds systematically to trauma of any of its parts
• An ade$uate blood supply is essential for normal body response to in"ury
• 2ormal healing is promoted &hen the &ound is free of foreign material
• )he e.tent of damage and the person's state of health affect &ound healing
 
"hases of Wound #ealing $
• Inflammatory
• Proliferation
 
%ocal Factors Affecting Wound #ealing
• Desiccation 6dehydration7
 
Systemic Factors Affecting Wound #ealing
• Age8 children and healthy adults heal more rapidly
• *irculation and o.ygenation8 ade$uate blood flo& is essential
• 2utritional status8 healing re$uires ade$uate nutrition
• 4ound condition8 specific condition of the &ound affects healing
• 3ealth status8 corticosteroid drugs and postoperati+e radiation therapy delay healing
• Immunosuppression
Wound Complications
Factors Affecting "ressure &lcer Deelopment
• Aging skin
• *hronic illnesses
• 2euromuscular disorders
'echanisms in "ressure &lcer Deelopment
• E.ternal pressure compressing blood +essels
• -riction or shearing forces tearing or in"uring blood +essels
 
"ressure &lcer Assessment
• Pain assessment
Stages of "ressure &lcers
• Stage II8 partial9thickness skin loss
• Stage III8 full9thickness skin loss( not in+ol+ing underlying fascia
• Stage IV8 full9thickness skin loss &ith e.tensi+e destruction
 
'easurement of a "ressure &lcer
• Si0e of &ound
• Depth of &ound
 
Cleaning a "ressure &lcer
• Use careful# gentle motions to minimi0e trauma
• Use ;<= normal saline solution to irrigate and clean the ulcer
• !eport any drainage or necrotic tissue
 
"sychological (ffects of Wounds
• *hange in body image
Wound Assessment
• Palpation for appearance# drainage# and pain
, Serous drainage9 clear serum
, Sanguineous drainage9 bloody drainage
 
"urposes of Wound Dressings
• !emo+e necrotic tissue
• Absorb drainage
• Protect &ound from further in"ury
• Protect skin surrounding &ound
"resence of Infection
• 4ound feels hot on palpation
• Drainage is increased and possibly purulent
• -oul odor may be noted
• 4ound edges may be separated# &ith dehiscence present
 
!ypes of Wound Dressings
• Dry or moist gau0e
• Iodoform gau0e# +aseline gau0e
Application of )andages
!ypes of )inders
• )9binder8 used for rectum# perineum# and groin area
• Sling8 used to support an arm
 
!ype of Drainage Systems
Color Classification of *pen Wounds
• ! ? red@protect
 
!opics for #ome #ealth Care !eaching
• Supplies
• Acti+ity:mobility
Factors Affecting the +esponse to #ot and Cold !reatments
• 5ethod and duration of application
• Degree of heat and cold applied
• Patient's age and physical condition
• Amount of body surface co+ered by the application
 
(ffects of Applying #eat
• Dilates peripheral blood +essels
• !educes muscle tension
, Electric heating pads
(ffects of Applying Cold
• *onstructs peripheral blood +essels