Unit 23 - Pressure Area Care

Understand the anatomy and physiology of the skin in relation to pressure area care

      1.1 Describe the anatomy and physiology of the skin in relation to skin breakdown and the development of pressure sores.

The top layer of the skin is the epidermis.   This is a layer which has no blood vessels and regenerates every 4-6 weeks. On the surface there are dead cells which flake off or are washed off.

The lowest layer of the epidermis interlocks with the dermis.   The dermis contains very small blood vessels called capillaries, pain touch receptors, hair follicles, sweat glands and sebaceous glands which secrete sebum (a substance rich in oil which lubricates the skin)

Next is the subcutaneous layer made of fatty tissue.   Here there are larger blood vessels and the fat helps to cushion, insulate and protect the body.

Pressure ulcers develop when localised injury to the skin and/ or the underlying tissue occurs, usually over a bony prominence, as a result of pressure, or pressure combined with shear and/ or friction.   A number of contributing factors are also associated with pressure ulcers such as ageing, lack of mobility, being obese, diet lacking in vital nutrients.

There are 4 stages in relation to the skin breaking down which causes pressure sores, it’s important that the correct stage is identified because this determines the sort of medical treatment an individual may require (stages below).

Skin may appear reddened like a bruise.   The integrity of the skin remains intact - there are no breaks or tears, but the area is at high risk of further breakdown.

Skin breaks open, wears away and forms an ulcer.

The sore worsens and extends beneath the skin surface, forming a small crater. There may be no pain at this stage due to nerve damage.   The risk of tissue death and infection are high.

Pressure sores progress, with extensive damage to deeper tissues (muscles, tendons and bones).   Serious...