The importance of a healthy skin condition
The skin is the largest organ of the human body, and consists of three interconnected layers, the epidermis, dermis and subcutaneous layer. It protects us from external influences such as extreme temperature or trauma. The skin fulfils a variety of vital functions for the human body and therefore needs to be looked after carefully.
There are many factors that can contribute to skin damage, such as: pressure, shearing and friction, reduced mobility and immobility, advancing age, disorders of the circulation, sensory impairment (for example, after a stroke), poor diet and dehydration, medication (for example, sedatives, steroids) and incontinence. Especially faeces can break down the skin due to residual enzymes and bacteria in the stool.
These are possible consequences of incontinence on the skin:
- When urine is in contact with the protection layer (hydrolipid film) of the skin, the risk of bacterial invasion is increased
- Urine soaked skin is softened and is more porous to bacteria
- Excoriation (damage to the surface of the skin) and rashes may occur
- Shearing (twisting) forces are made worse when the skin is damp or moist
- In older adults the skin is thinner, lacks elasticity and is more easily damaged
In order to reduce the risk of skin problems occurring when you care for an incontinent person:
- Assess the areas at risk at every opportunity, for example when helping the client off the toilet
- Always report redness, sores and marks immediately
- Use unscented products to cleanse the skin. Preferably use skin cleansing products which support the protective function of the skin
- Avoid vigorous rubbing and drying of the skin
- Be aware of how long the client has been immobile
- Ensure clothing and bedding is wrinkle free
- Do not use talcum powder
- Avoid oil or silicone based creams as these may block the top layer of an absorbent product, trapping urine next to the skin
- Only use prescribed creams on the skin, apply only in the area affected and in the smallest amount required to be effective
- Ensure clients are using the pressure relieving equipment recommended by the nurse in charge
