Lecture: Skin Integrity and Wound Care (Part 1)

Welcome to Professor D's lecture on skin integrity and wound care, focusing on the causes, stages, risk factors, and interventions related to this important topic. This is the first part of a two-part series.

Key Questions and Concepts

Pressure Ulcers

• Primary Cause: Tissue ischemia due to pressure, leading to decreased blood flow, oxygen, and nutrients.
  • Risk Factors: Poor nutrition, immobility, incontinence, obesity, or being emaciated.
  • Misconception: Poor nutrition is a risk factor, not a direct cause.

Stages of Pressure Ulcers

• Stage 1: Reddened area, non-blanchable, skin intact.
• Stage 2: Break in skin, small abrasion, affects epidermis or dermis.
• Stage 3: Extends to subcutaneous tissue.
• Stage 4: Extends to bone.

Interventions for Skin Integrity

• Turning and Positioning: Maintain a written schedule for repositioning every 2 hours to relieve pressure.
• Avoid High Fowlers Position: Causes shearing forces, increasing risk of skin breakdown.
• Appropriate Turning: Ensure frequent turning to prevent prolonged pressure on any one area.

Skin Care for Reddened Areas

• Mild Soap and Protective Moisturizer: Clean with mild soap, dry, and apply a protective barrier. Avoid harsh treatments like hydrogen peroxide.

First Aid for Wounds

• Elevate Bleeding Parts: Apply pressure and elevate to minimize bleeding.
• Do Not Remove Penetrating Objects: They may prevent hemorrhage; leave removal to surgeons.

Preventing Dehiscence

• Splinting with a Pillow: Use a pillow to splint incision sites during coughing or deep breathing to prevent dehiscence.

Fluid Drainage and Skin Integrity

• Types of Drainages:
  • Serous: Clear, watery fluid.
  • Purulent: Thick, yellow/green, malodorous, suggests infection.
  • Cerebral Spinal Fluid: Clear with a yellow halo or glucose positive, requires testing.
  • Serosanguineous: Pale red, a mix of clear and blood.

Risk from Exposure to Body Fluids

• Greatest Risk: Pancreatic fluids due to enzymes that break down tissues rapidly.

Cleaning Wounds Appropriately

• Technique: Start from the center (drainage site) and move outward in circular motions with a single swipe per swab.

Cold Application for Injuries

• RICE Method: Rest, Ice, Compression, Elevation for fractures and sprains.

Use of Abdominal Binder

• Ventilatory Capacity: Ensure the patient can breathe, binder should be snug but not loose.

Preventing Pressure Ulcers

• Avoid High Head Elevation: Minimize elevation to reduce shearing forces.
• Positioning: Avoid direct pressure on bony prominences.

Conclusion

• This video is part of a two-part series; the second part will continue to explore these topics.

Reminder: Like, comment, and subscribe for more insights and the upcoming second part of this series!