Anatomy of the skin Aims and objectives PowerPoint Presentation, PPT - DocSlides

Download kittie-lecroy | 2018-07-11 | General To understand the underlying structures of the skin. To gain a basic understanding of the process of wound healing.. To be able to identify different tissue types in areas such as the wound bed, wound edge and surrounding skin. ID: 663620

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Any delay in a reassessment may result in inappropriate treatment

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Slide1

Anatomy of the skin

Slide2

Aims and objectives

To understand the underlying structures of the skin

To gain a basic understanding of the process of wound healing.

To be able to identify different tissue types in areas such as the wound bed, wound edge and surrounding skin

Slide3

Anatomy of the skin

Slide4

Is it important to know the Structure and functions of the skin?

Slide5

How many layers does the skin consist of?

Slide6

Largest and most visible organ

Made up of two main layers:

Epidermis – very thin layer and is firmly attached to the dermis at the dermo- epidermal junction.

Dermis- made up of two layers comprising of fibrous proteins, collagen and elastin which give skin its strength and elasticity.

Below dermis is subcutaneous layer , this provides support to the dermis and stores fat which protects the internal structures.

Slide7

Does the skin vary in depth?

Slide8

Thinnest over eyelids -O.1mm

Thickest over palms and soles of the feet – 1mm

The skin is the largest organ of the body it weighs between 6-8 1bs

It has a surface area of 20 square feet.

Slide9

What are the functions of the skin?

Slide10

Protection of internal structures – physical barrier to microorganisms and foreign matter.

Acid PH helps to prevent infection

Slide11

Sensory perception-

Allows you to feel pain, pressure heat this helps us to identify potential dangers and avoid injury

Slide12

Thermoregulation- Blood vessels constrict or dilate to raise or lower body temperature. Sweat production promotes cooling

Slide13

Excretion –

Transmits small amounts of water and body waste via sweat

Helps to prevent dehydration.

Slide14

Metabolism-Photochemical reaction in the skin produces Vitamin D essential for metabolism of calcium

Slide15

Absorption-Some substances can be absorbed directly into blood stream

Slide16

Communication

Slide17

Functions of the skin that declines with age.

Flattening of the dermal-epidermal junction, increased susceptibility to friction/ shearing forces resulting in blistering.

Decreased sensitivity to pain perception

Epidermis becomes thinner and flatter , uneven distribution of melanocytes leading to uneven pigmentation.

Skin becomes wrinkled due to depletion of elastic fibres.

Skin becomes dry as a result of atrophy of sebaceous glands

Baraboski (2003) and Beldon (2006)

Slide18

How do wounds heal?

Slide19

19

Classification of wound healing

Wounds that heal by primary intention e.g. incisional wounds

Wounds that heal by secondary intention e.g. pressure ulcers

Wounds that heal by tertiary intention e.g. delayed suture

Slide20

Wounds characterised by whether they are acute or chronic

Slide21

21

Acute wounds

Characterised by:

No underlying aetiology i.e. trauma

Short duration

Normal inflammatory phase

Heal and do not breakdown

Slide22

22

Chronic wounds

Characterised by:

Underlying pathology e.g. venous insufficiency

Prolonged duration

Hyperactive state

Persistent state of inflammation

Slide23

Wounds go through 4 distinct phases

Slide24

Normal Wound Healing Response

HAEMOSTASIS

INFLAMMATION

PROLIFERATION

MATURATION

MINUTES

DAYS

WEEKS

MONTHS / YEARS

Platelets

Fibrin

Neutrophils

Macrophages

Lymphocytes

Proteoglycans

Fibroblasts

Collagen

Angiogenesis

Collagen remodelling

Scar maturation

(whru)

Slide25

Haemostasis

Starts immediately after injury.

Blood vessel contraction (vasoconstriction)

Slide26

Inflammatory phase

Occurs between 0-3 days

Slide27

Proliferation

0-24 days

Slide28

Maturation

20 days – 2 years

Closure of wound and re-epithelisation.

Scar maturation

Slide29

What factors may affect wound healing?

Slide30

Factors Affecting Healing

Systemic

Age

Anaemia

Nutrition

Medications e.g.: Anti inflammatory, Cytotoxic drugs, steroids

Chronic health conditions

eg

:Diabetes Mellitus

Systemic infection (Bowler & Davies, 1999

)

Oxygenation

Smoking

Psychological factors

Temperature

Slide31

Factors affecting healing

Local Factors

Blood supply

Denervation

Haematoma

Local Infection

Duration

Wound bed condition

Anatomical site

Size of wound

Slide32

Assessment of a wound is the responsibility of the qualified member of staff

You should ensure that this has been undertaken and a treatment plan has been established.

Slide33

Remember

The selection of dressings or bandages without accurately undertaking a wound assessment taking into account underlying factors that may delay wound healing may result in costly treatments that are inappropriate and are not successful!

Slide34

Clinical appearance of wound bed

Colour

Physiological State

Black Necrotic

Yellow Sloughy

Red Granulating

Pink Epithelializing

Green

Infected?

Slide35

35

Characteristics of granulation tissue

Healthy tissue

Bright red

Moist

Shiny

Does not bleed

Unhealthy tissue

Dark red

Dehydrated

Dull

Bleeds easily

S

Slide36

Granulating

(WHRU)

Slide37

(WHRU)

Necrosis

Slide38

Slough

Slide39

Clinical appearance

of

surrounding skin

Slide40

Maceration

Slide41

Excoriation

Slide42

Erythema and oedema

Slide43

Eczema and dry skin

Slide44

Exudate

Quantity – Small , moderate copious is dressing containing exudate?

Colour – Green? serous?, haemoserrous?

Consistency – Thick?Thin,

Slide45

Pain

When does it occur?

How bad (intense) is it?

How does the patient

describe it?

What makes it better?

Slide46

If there are any changes in the wound report immediately to your nurse in charge

Any delay in a reassessment may result in inappropriate treatment

Slide47

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