Skin Care

by the WoundSource Editors Best practice in skin care focuses on the prevention of skin breakdown and the treatment of persons with altered skin integrity. When we ask what causes skin damage we should consider the conditions that can harm the skin, including excessive moisture and overhydration, altered pH of the skin, the presence of fecal enzymes and pathogens, and characteristics of incontinence such as the volume and frequency of the output and whether the output is urine, feces, or both. If left untreated or not treated appropriately, moisture-associated skin damage or MASD can lead to further complications such as Candida infections, bacterial overgrowth, pressure injuries, and medical adhesive-related skin injury (MARSI). These can occur individually or overlap, which can make them even more difficult to manage. Today our focus is to discuss each of these complications of MASD in more detail and address some of the most common issues leading to their development.

Yy Margaret Heale, RN, MSc, CWOCN Hi blog buddies, Matron Marley here. I may be an ex-matron, but I may just have some gems for you. Today I would like to cast the threads (strings even) of time back to when I was a new nurse rather than a matron. The reason being the change happened then. I remembered it today when a rather frail lady caught her arm on a door mechanism. It tore such a huge triangle of her delicate skin, and my goodness did it bleed. I put on the gloves I keep in my pocket and pressed several napkins on it while the nurse went for supplies. She returned promptly with gloves, hand gel, gauze, skin prep, saline, cotton swabs, Xeroform, net and Steri-Strips™ (great invention, right up there with Velcro and cyanoacrylate).

By Aletha Tippett MD The other day I received a phone call from a dear physician friend of mine who works tirelessly in the field of pressure support and pressure ulcer prevention. He had been talking to some older nurses who told him that "in their day" they kept their patients lubed up and never had a skin problem. He knows that I advocate vigorous skin lubrication and sought guidance.

By Cheryl Carver, LPN, WCC, CWCA, FACCWS, DAPWCA, CLTC With approximately $20 billion being spent a year on advanced wound care supplies, cost containment is a sought after goal. Long-term care facilities battle cutting costs under one reimbursement system like everyone else, but I assure you this challenge can be simplified, while continuing to bolster quality of care. I have learned that to contain cost, you must use experience, knowledge, and strong project management. So how do we accomplish this? I have broken down a cost containment plan for your long-term care facility. These key points will help you.

To understand the concepts of a wound and wound healing, we must examine the skin and its pathophysiology, as well as its unique structures and functions. Skin care and wound management must be grounded in a comprehensive knowledge base of the structure and functions of the skin. The skin is the largest organ of the body, covering approximately 18 square feet and weighing about 12 pounds, or up to 15% of total adult body weight. It requires one-third of an individual’s circulating blood volume to sustain it. Normal surface skin temperature is 92 degrees, compared with a core body temperature average of 98.6 degrees.

The purpose of this blog is to bring special attention to common dermatologic conditions connected with drug addiction. Although drugs are well known for their significant impact on all body organs (liver, bladder, stomach, and kidneys), various physical manifestations of drug use are often unknown or underrecognized. Many clinicians and even dermatologists fail to see the many symptoms of drug misuse in the skin. Skin lesions caused by substance use may be induced by the drug itself, an allergic reaction, the drug administration method, or any contaminants or infectious agents that may have been mixed in with the drug. It is possible to identify substance users based on the shape and pattern of their skin conditions. Clinicians can learn these signs to better help patients.

By Paula Erwin-Toth MSN, RN, CWOCN, CNS, FAAN Health care professionals recognize there seem to be 'seasons' for certain diseases and conditions. Spring and fall see a rise in flare ups of gastrointestinal disorders, such as inflammatory bowel diseases and seasonal allergies. Summer months bring an increase in traumatic events such as drownings, gunshot wounds and automobile accidents. Development of pressure ulcers does not follow a seasonal pattern—they occur at a higher than acceptable frequency throughout the year.

By Paula Erwin-Toth MSN, RN, CWOCN, CNS Winter weather is upon us and that brings a whole host of challenges. Our skin is more liable to experience dryness, cracking and breakdown. Everyone, especially older adults, are more vulnerable to falls due to slippery steps and walkways. Shoveling heavy, wet snow has been associated with increased risk of heart attacks. Just heading to the mailbox, grocery store or the doctor's office can spell disaster. All of these situations can combine for a 'perfect storm' for risk of skin breakdown at home and all healthcare settings.

By Margaret Heale, RN, MSc, CWOCN I was in the shower getting ready for my day volunteering at the nursing home and my mind bemoaned again how much I miss bathing. Relaxing in a deep hot bath, preferably with bubbles, background music and a cool drink...heavenly! Then I started thinking about how much the process of personal hygiene has changed since I was matron, way back when. As a child we bathed on Sundays which was great because the house was warmer on Sundays. I remember being really surprised when I went into nursing that we washed patients every day. By the time I was matron we had got rid of rubber draw sheets and had plastic ones. The rubber absorbed some of the odor from the urine, quite unpleasant. Linen changes were more frequent and we ran out of linen less frequently than earlier in my career. Most hospitals had their own laundry back then.