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WCET Wound Education Toolkit

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WCET: Wound Care

Unit 1- Anatomy and physiology of the skin

WCET™ a world of expert professional nursing care for people with ostomy, wound or continence needs

© WCET 2016
 Skin Anatomy and Physiology

•  Largest organ of the body

•  Acidic pH- ranges 4.5 to 5.5
•  Thickness varies – 0.5 t0 6.0
•  Skin influences by other medical condiGons:
–  MalnutriGon
–  Renal failure
–  Respiratory issues
–  Cardiovascular disease
UNIT 1 Anatomy and physiology of the skin ©WCET 2016
 Skin Anatomy: 3 Layers of Skin
Skin surface

Epidermis
(outermost layer)

Basement Membrane: anchors epidermis to dermis

Dermis
(inner layer)

Subcutaneous Tissue
(Fatty layer)

UNIT 1 Anatomy and physiology of the skin ©WCET 2016

 Layers of the Epidermis
Skin surface

• Stratum Corneum
• Stratum Lucidum
• Stratum Granulosum
• Stratum Spinosum
• Stratum GerinaGvum (Basale)

UNIT 1 Anatomy and physiology of the skin ©WCET 2016

 Dermis
• Ranges in thickness (2-4 mm)
• Gives skin its bulk
• Full thickness wounds through dermis
• Contains:
Blood vessels, Hair follicles,
lymphaIc vessels, sebaceous glands,
sweat glands
UNIT 1 Anatomy and physiology of the skin ©WCET 2016
 Dermis
• Strong structural material
• ElasIn and collagen

• Primary cell:
Fibroblast - which produces collagen
Collagen anchors dermis to subcutaneous tissue layer

UNIT 1 Anatomy and physiology of the skin ©WCET 2016

 Dermis- Two Layers
Skin surface

• Papillary dermis
Collagen fibers
Gives dermis “tensile strength

• Reticular dermis
Elastin structural protein
Provides extensibility of dermis

UNIT 1 Anatomy and physiology of the skin ©WCET 2016

 Subcutaneous Tissue
(Hypodermis)
•  Dense, connecIve and adipose Issue
High proporGon of fat cells
•  Houses major vessels, lymphaIcs and
nerves
Few small blood cells
•  Acts as heat insulator and shock
absorber
UNIT 1 Anatomy and physiology of the skin ©WCET 2016
 FuncGons of the Skin
ü ProtecIon
ü SensaIon
ü RegulaIon of Body Temperature
ü ExcreIon
ü Metabolism
ü Storage
ü AbsorpIon
ü Body image and expression/communicaIon
UNIT 1 Anatomy and physiology of the skin ©WCET 2016
 Effects of Aging
•  Difficult to disInguish between sun damage
and true aging
•  Skin becomes less elasIc

•  Bruises easier

•  Higher risk of infecIon

Photo © Ayello 2015

UNIT 1 Anatomy and physiology of the skin ©WCET 2016

 Aging conInued

•  Slower to heal

•  Decreased sensaIon

•  Increased risk of:

–  fricIon and shear injuries
–  thermal (hot or cold) injuries Photo © Ayello 2015

–  overdose from transdermal medicaIons

© Zulkowski &Ayello2007

UNIT 1 Anatomy and physiology of the skin ©WCET 2016

 Therefore:

•  Skin tears more common

•  Less able to withstand

pressure Photo: K. Zulkowski

•  More prone to maceraIon and shear injury

UNIT 1 Anatomy and physiology of the skin ©WCET 2016

 Know your paGent’s skin

•  Know your paIents risk for

skin injury

•  Plan care to encourage strengths

and overcome weakness

©WCET 2016 UNIT 1 Anatomy and physiology of the skin

Photo © Ayello 2015
 Wound
WCET Wound Education Toolkit
TM

C
Education
T

WCET: Wound Care

Unit 1- Anatomy and physiology of the skin
WCET™ a world of expert professional nursing care for people with ostomy, wound or continence needs

© WCET 2016