Skin & Wound

⸻

🩹 Skin Layers

Epidermis:

The outermost layer of the skin that acts as a barrier against bacteria, chemicals, and physical injury.

Dermis:

The middle layer of skin beneath the epidermis; contains blood vessels, nerves, sweat glands, and hair follicles.

Subcutaneous Tissue:

The deepest layer of the skin made mostly of fat and connective tissue; it cushions, insulates, and connects the skin to underlying muscles.

⸻

⚡ Types of Wounds

Acute Wound:

A wound that heals quickly and predictably, such as a surgical incision or paper cut.

Chronic Wound:

A wound that fails to heal within the expected time frame (usually over 4–6 weeks), often due to poor circulation, diabetes, or infection.

Intentional Wound:

A wound created for a therapeutic purpose under sterile conditions, such as surgery or a venipuncture.

Unintentional Wound:

An accidental wound caused by trauma, such as a burn, cut, or fall.

Open Wound:

A break in the skin surface where underlying tissue is exposed, such as a laceration or abrasion.

Closed Wound:

The skin remains intact, but underlying tissue is damaged (e.g., a bruise or contusion).

Abrasion:

A superficial wound where only the top layer of skin (epidermis) is scraped away.

Laceration:

A deep cut or tear in the skin and underlying tissue caused by trauma.

Incision:

A clean, straight cut made intentionally by a sharp instrument during surgery.

Penetrating Wound:

A wound caused by an object entering the skin and underlying tissues (e.g., stab wound).

Contusion:

A bruise resulting from blunt trauma causing bleeding under the skin but no break in the surface.

Thermal Wound:

Damage to the skin caused by heat, cold, electricity, or radiation (e.g., burns or frostbite).

Chemical Wound:

Skin or tissue damage caused by exposure to harsh chemicals such as acids or alkalis.

Pressure Injury (Pressure Ulcer):

Localized damage to skin and tissue caused by prolonged pressure, usually over bony areas (e.g., heel, sacrum).

Pressure Ulcer:

Another term for pressure injury; caused by unrelieved pressure reducing blood flow to skin and tissues.

Diabetic Ulcer:

An open sore or wound that occurs most often on the feet of people with diabetes due to poor circulation and nerve damage.

Venous Ulcers:

Wounds on the lower legs caused by poor venous return, leading to pooling of blood and skin breakdown.

Arterial Ulcers:

Wounds caused by poor arterial circulation (oxygenated blood flow) to the legs or feet.

⸻

🧬 Wound Healing & Complications

Hemostasis:

The first stage of wound healing when blood vessels constrict and clotting occurs to stop bleeding.

Inflammatory (Phase):

The second stage of healing where white blood cells clean the wound and control infection, causing redness, warmth, and swelling.

Proliferation (Phase):

The stage of healing where new tissue, collagen, and blood vessels form to repair the wound.

Erythema:

Redness of the skin caused by increased blood flow, often a sign of inflammation or irritation.

Dehiscence:

The partial or complete separation of a surgical incision or wound after it has been closed.

Evisceration:

A severe form of dehiscence where internal organs protrude through the opened wound.

Hemorrhage:

Excessive or uncontrolled bleeding from a wound or blood vessel.

Infection:

The invasion of microorganisms in the wound, causing delayed healing, pus, redness, and warmth.

Fistula:

An abnormal passage or connection between two organs, or between an organ and the skin.

Slough:

Soft, yellow or white tissue in a wound made of dead cells and debris that need to be removed for healing.

Eschar:

Thick, black or brown dead tissue (scab) that forms over a wound as it heals or after tissue death.

⸻

💉 Wound Drainage Types

Sanguineous:

Drainage that is primarily blood; usually seen in early wound healing.

Serous:

Clear or slightly yellow watery drainage; a normal part of healing.

Serosanguineous:

Thin, watery drainage that is pinkish due to a mix of serum and small amounts of blood.

Purulent:

Thick, cloudy drainage that is yellow, green, or brown, indicating infection.

⸻

☢ Other Terms

Irradiation:

Exposure to radiation, which can damage tissues and impair wound healing.

Mutation:

A change in the DNA of cells, which may affect healing or cause abnormal tissue growth.

⸻

Loading…

Wound Healing

Types of Wounds

Acute

•Incision – skin cut from sharp tool

•Contusion – underlying soft tissue injury from blunt tool

•Abrasion – friction cut top layer of skin

•Laceration – skin tearing with blunt tool

•Puncture – blunt or sharp tool

•Penetrating – foreign object

•Avulsion – tear blood vessels nerves

•Chemical, thermal or irradiation

Chronic

•Pressure ulcers – cut off circulation

•Venous – poor/no blood return (vein)

•Arterial – no blood flow or perfusion (artery)

•Diabetic – diabetic neuropathy

Normal Process of Wound Healing

Delays Wound Healing

Factors

Description

Tests

Infection

Infections diverts resources to repair wounds.

WBC – Neutrophils, Lymphocytes, Monocytes

Poor Blood Circulation

Perfusion problems with impaired circulation – PAD or diabetes

RBC, HgbA1C

Nutritional Deficiencies

Regulatory nutrients and macro such as protein to repair tissue

Albumin, prealbumin, Vit C, Zinc

Chronic Health Condition

Diabetes [reduce WBC], cancer [nutrition], cardiovascular [circulation] diseases

HgbA1C, WBC – diabetes

CK-MB, CRP, BNP – cardiac

Cancer markers

Unhealthy Lifestyle

Suppressed I inflammatory response and blood flow caused by nicotine or alcohol

WBC

RBC

Medication

Anti-inflammatory and immunosuppressant [prednisone]

WBC

Cold vs Heat Therapy

Cold

•Reduce muscle soreness – vasoconstriction that numbs area ↓ inflammation

•Decrease inflammation - ↓ inflammation in acute injuries

•Improves recovery – less muscle soreness in cryotherapy

•Boost mood/energy – release endorphins [well being]

•Support immune system - ↑ WBC circulation

Hot

•Vasodilation - ↑ blood flow that bring nutrients

•Muscle relaxation - ↓ muscle spasm/tension

•Pain reduction – interrupts pain signals to the brain

•Improves tissue elasticity – softens connective tissue improving flexibility and range of motion

Wound Assessment

•Size

•Depth

•Undermining

•Tunneling

Loading…

Pressure Ulcer Stages

Dressing Types

Wound Dressings

Care Plan for Impaired Skin

Plan of Care

•Thorough skin assessment – identify areas at risk for breakdown

•Implement wound care protocols – cleaning, dressing, and protecting injured areas

•Position client comfortably – reposition every two hours

•Ensure adequate skin perfusion – maintain dry skin [incontinence]

•Promote proper nutrition and hydration – support tissue repair and healing [water is regulatory nutrient]