SKIN INTEGRITY I 1 1 FUNCTIONS OF SKIN

SKIN INTEGRITY, I 1

1. FUNCTIONS OF SKIN & MUCOUS MEMBRANES � PROTECTION � THERMOREGULATION � SENSATION � VITAMIN D � ABSORPTION/ELIMINATION 2

2. FACTORS AFFECTING SKIN INTEGRITY � DEVELOPMENTAL CONSIDERATIONS � LIFESTYLE � HEALTH CHANGES � ILLNESS � DIAGNOSTIC TESTS � THERAPEUTIC MEASURES 3

3. CLASSIFICATION OF WOUNDS � CLASSIFIED AS: INTENTIONAL/UNINTENTIONAL CLOSED/OPEN ACUTE/CHRONIC 4

Intentional/unintentional 5

Closed vs. open 6

Acute vs, chronic 7

TYPES OF WOUNDS �INCISION �CONTUSION �ABRASION �LACERATION �PUNCTURE �PENETRATING �AVULSION �MICROBIAL �CHEMICAL �THERMAL �IRRADIATION �PRESSURE �VENOUS �ARTERIAL �DIABETIC 8

INCISION CONTUSION 9

ABRASION LACERATION 10

PUNCTURE PENETRATING 11

AVULSION MICROBIAL 12

CHEMICAL THERMAL 13

RADIATION PRESSURE 14

VENOUS ARTERIAL 15

DIABETIC ULCERS 16

WOUND HEALING � 1 ST INTENTION (PRIMARY) � 2 ND INTENTION (SECONDARY � 3 RD INTENTION (TERTIARY) 17

1 ST INTENTION HEALING �WELL APPROXIMATED EDGES �MINIMAL TISSUE LOSS �EX. INTENTIONAL WOUNDS 18

First intention healing 19

2 ND INTENTION HEALING �EDGES NOT WELL APPROXIMATED �WOUND CAN BE CONTAMINATED �TAKE LONGER TO HEAL, SCAR LARGER �EX. TRAUMA, BURNS 20

Second intention healing 21

3 RD INTENTION HEALING �LEFT OPEN TO ALLOW EDEMA OR INFECTION TO RESOLVE �LATER CLOSED 22

Third intention healing 23

STAGES OF HEALING � TISSUE HEALING AND REPAIR FOLLOW THE SAME PHASES IN HEALING, ALTHOUGH DIFFERENCES OCCUR IN LENGTH OF TIME REQUIRED FOR EACH STAGE. � THE PHASES ARE: HOMEOSTASIS INFLAMMATION PROLIFERATION MATURATION 24

STAGES DESCRIPTION HOMEOSTASIS BLOOD VESSELS CONSTRICT; PLATELETS ACTIVATION. THEREAFTER, VASODILATION INFLAMMATORY LASTS 4 -6 DAYS WHITE BLOOD CELLS AND GROWTH FACTORS PRESENT PROLIFERATION LASTS FOR SEVERAL WEEKS FIBROBLASTS FILL IN WOUND, GRANULATION TISSUE APPEARS MATURATION REMODELING OF COLAGENSCAR TISSUE PRESENT. 25

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FACTORS IN WOUND HEALING �LOCAL PRESSURE DESSICATION/MACERATION REPEATED TRAUMA EDEMA INFECTION NECROSIS 27

�SYSTEMIC AGE CIRCULATION & O 2 NUTRITION NATURE OF INJURY HEALTH STATUS 28

COMPLICATIONS �INFECTION �HEMORRHAGE �DEHISCENCE/EVISCERATION �FISTULA �PHYCHOLOGICAL EFFECTS 29

DEHISCENCE EVISCERATION 30

fistulas 31