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UNIT 4 Supporting Physiological Function
turn him in bed, you see a 10-cm by 6-cm reddened area on his coccyx and a 2-cm by 3-cm purple bruise-like area on his left heel. Mr. Harmon now has three wounds, an intentional surgical wound and two pressure injuries that have resulted Meet Your Patient (continued)
from his impaired mobility. How will you care for each of these wounds? What factors contributed to each of the wounds? How will you promote healing?
Theoretical Knowledge knowing why
see how the concepts of skin integrity and wound are related; they are opposites. You will use your knowledge of both concepts as you protect your patients’ skin and promote the physiological process of wound healing.
The integumentary system consists of the skin, hair, nails, sweat glands, and subcutaneous tissue below the skin. The skin is the largest organ of the body (covering about 20 square feet). The major functions of the skin include protection of the internal organs, unique identifi- cation of an individual, thermoregulation, metabolism of nutrients and metabolic waste products, and sensation. ABOUT THE KEY CONCEPTS For optimal function, skin integrity must be preserved— that is, all layers of the skin must be intact. A wound is a disruption in the normal skin integrity. It is easy to
WHAT FACTORS AFFECT SKIN INTEGRITY?
For optimal function, all layers of the skin must be intact. Breaks in the skin (e.g., surgical incisions, inju- ries) increase the risk of infection. In the following sec- tions, you will learn about factors that influence the ability to maintain intact skin and heal wounds (e.g., age and mobility). To understand skin integrity, you need to understand the structure of the skin (Fig. 32-1).
Stratum germinativum
Pore
Stratum corneum
Epidermis
Papillary layer with capillaries
Sebaceous gland
Dermis
Receptor for touch (encapsulated)
Pilomotor muscle
Hair follicle
Subcutaneous tissue
Receptor for pressure (encapsulated)
Fascia of muscle
Adipose tissue
Nerve
Eccrine sweat gland
Free nerve ending
Arteriole
Venule
FIGURE 32-1 The structure of the skin.
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