1. What am I? Can you guess?

2. (Integumentary System)

3. The Integumentary System Cristine Luca RN BSN Molloy College

4. Objectives 1. Functions 2. Layers 3. Wounds and prevention

5. Functions of Skin Our skin is the largest and most largely used organ  SENSES- nerve receptors (pain)  PROTECTS- from chemicals and UV light  SECRETES- glands (sebaceous or sweat)  THERMO-REGULATES- keeps us cool  Overview of Integumentary System Overview of Integumentary System

6. Layers of Skin  Epidermis  Dermis  Hypodermis (Subcutaneous)

7. Accessory Structures  Hair  shaft and root  Skin  sebaceous and sweat glands  Nails

8. Skin Breakdown  Causes  Immobility  Which of the following are common places for skin break down?  Malnutrition  Medical devices  Prevention  Turning and positioning  Proper nutrition  Positioning devices  Skin Protectants  Silicon dressings, moisture barrier creams, foam dressings, liquid skin barriers

9. What device can cause skin breakdown? Any device or item will cause skin breakdown! Any place pressure is applied to skin breakdown will occur! a. oxygen tubing b. tracheostomy c. an IV d. pulse oximeter probe

10. Stages of Skin Breakdown Stage I Stage III Stage II Stage VI Unstageable DTI IAD- According to Gray, Bliss, Doughty, Ermer- Seltun, Kennedy-Evans, & Palmer (2007) incontinence-associated dermatitis (IAD) is an inflammation of the skin that occurs when urine or stool comes into contact with perineal or perigenital skin.

11. Photos courtesy of NPUAP & WOCN

12. Resources for You  WOCN WOCN  NPUAP NPUAP  Principles of Skin Care Principles of Skin Care  Learning Nurse- Pressure Ulcers Learning Nurse- Pressure Ulcers  Test your Knowledge! Test your Knowledge! Become a skin/ wound care champion in your place of work!

13. References Gray, M., Bliss, D. Z., Doughty, D. B., Ermer-Seltun, J., Kennedy-Evans, K. L., & Palmer, M. H. (2007). Incontinence ‐ associated dermatitis: A consensus. Journal of Wound, Ostomy & Continence Nursing, 34 (1) 45-54. National Pressure Ulcer Advisory Board. (2015). Wound, Ostomy and Continence Nurse’s Society. (2015).