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Skin integrity in older adults: pressure-prone, inaccessible areas of the body

02 January 2020
Volume 25 · Issue 1


Good skin integrity is vital to good health because the skin acts as a barrier to microbes and toxins, as well as physical stressors such as sunlight and radiation. It is well known that the skin loses integrity with the ageing process, and this makes older adults susceptible to pressure injury. Additionally, older skin takes longer to heal where there are injuries or breaks. This article looks at what skin integrity is by briefly outlining the physiology of the skin. It discusses how skin integrity can be impaired, what can be done to maintain skin integrity and skin health, and why skin integrity is important for pressure ulcer prevention. Some of the factors that can make skin care difficult are discussed, in addition to the role of community nurses in helping patients engage in skin care. The article outlines how community nurses can identify when there is skin integrity risk or damage and support patients and carers or relatives, in maintaining skin integrity.

The skin is the largest organ in the human body, weighing about 3 kg (Bianchi and Cameron, 2008; Bonifant and Holloway, 2019), and serves multiple functions. It provides barrier protection for the entire body, preventing organisms and toxins from entering the body and preventing damage to internal organs and tissues. It also protects against damage from ultraviolet radiation and strong sunlight, and helps regulate the body's temperature. Additionally, the skin provides sensory input, and stores fat, water and vitamin D (Lavers, 2017).

The skin is at its thickest on the palms of the hands and soles of the feet and thinnest on the eyelids (Lavers, 2017). It comprises three separate layers—the epidermis, the dermis and the hypodermis—all of which are important to its proper functioning (Figure 1).

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