Importance of Skin and Daisy Wounds Case Study Paper Example

Introduction

The skins form the most abundant tissue in the body of a human body, accounting for 15 percent of the total body weight of an adult. It plays a significant function in the human body comprising of guard against chemical, biological assailants, external physical as well as deterrence of excess water loss from the body and a role in thermoregulation. Hibbert et al. (2016) define skins as an unbroken with the mucous membranes lining the body's surface. The skin is made of three layers. The three layers the epidermis, the dermis, and, subcutaneous muscle. The top level, the dermis, comprises of a specific constellation of cells known as keratinocytes that create keratin, a long threadlike protein with shielding role. The dermis is the middle layer that is made of the fibrillar structural protein called collagen. The dermis lies on the subcutaneous tissue or panniculus.

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Changes skin experience as one gets old

As the skin ages it ends to growing thinner and loses resistance. Hence, it becomes more wrinkly and loose. The content of the fat beneath the skin tend to depreciate, making the surfaces more disposed to bruising, more delicate and easily injured. Usually, a reduced blood supply means any damage to the skin may take longer to heal and regulation of body temperature is not as effective. The loss of natural moisturizing elements in the older person' skin also decreases skin hydration and results in it to become peeling and dry. Dry skin is itchy and can lead to grazing and skin breakdown,

Causes of skin damage

Cuts, friction, tearing, scrape, constant moisture, continuous pressure, bruises, and, shearing forces are the main factors to damaged skin. However, in the elderly individuals, the skin is more fragile and less resilient, therefore is at high risk of experiencing damages from the underlying factors of skin damage.

Moreover, while senior can recover from most of the abrasion, cuts, and, lesions, the wound healing process takes extensive time among the older individual as compared to younger individuals. National Institutes of Health claims that the inflammatory reaction to a wound in the primary stage when the blood vessels expand to enable essential nutrients and white blood cells to access the region affected is significantly slow. In the second phase, proliferation is also slow and in the final stage of wound healing process, a maturation that extends for years, the restoration of collagen which decreases the size of the wound and facilitates returning of skin to it is natural color is affected. The process eventually happens but too much less magnitude as people age. Therefore, due to high risk and slow wound healing process among the aged, there is a need for giving the aged maximum care to prevent them from developing further complications. Before giving quality care to wounded older adult, nurses are required to provide an assessment of the wound using a structured approach that will enable them to effectively plan, implement, and, care for a patient lead to a good standard of patient care.

Outline the two types of wounds Daisy has (using the information in week 1) and discuss them concerning the phases of wound healing.

1. What types of wounds does she have in week 1? Describe

In the process of Daisy falling, she obtained two physical wounds. These wounds are large skin tear, which is estimated to nearly 4Cm x 5Cm located on her left knee and femur fracture on her right leg that was confirmed using X-ray. Daisy being 72 years old falls on the category of senior people, which are associated with the skin of low integrity and high risk of getting infections. Below is a discussion of how low skin integrity exposed her to the wounds

Femur Fracture

The femur is the lengthiest bone in the human body. This fracture frequently occurs at the hip, but on some occasion, it can occur at the lower extremities. A femur fracture is most prevalent not only in young males from high- energy damage but also, senior women in low energy injuries (Rogmark & Leonardsson, 2016). However, the difference between the two groups is that senior women have a low survival rate

These types of fractures are most prevalent in young men from high-energy injuries and senior women in low-energy injuries. The largest difference between these two groups is the survival rate.

Skin tear

Skin tears often result from severe friction between the skin and a sharp surface, provoking detachment between the epidermis and dermis layers. Some are unavoidable for instance, tripping of Daisy's leg on her way back home was inescapable, but several are considered preventable. This problem is perceived to common among older adults old age being among those factors. Strazzieri-Pulido et al. (2017) claim that one of the risk factors to skin tear is old age, among others In older patients, most skin tears occur on the extremities, often in arms, lower limbs and, dorsal elements of the hand seconding why Daisy got skin tear on the knee. Skin tears can cause significant pain and severely affect the quality of life. With the aging population, it is vital that health professionals ensure they are proficient and assertive in the management of skins tears. As part of assessing the wound, nurses are required to stage of the wound healing process to determine what of wound care a patient will be given

2. What phases of wound healing are she is?

The medical community suggests that there are three main stages of wound healing (Han and Ceiiley, 2017). These levels are:

Inflammation

According to Han and Ceilley (2017), inflammation is the first stage, the body's natural reaction to injury. After the wound is exacted, the process of homeostatic commences in which the blood vessels tighten and cover themselves as the platelets generate substances, which form a clot to stop bleeding. After successful completion of homeostasis, the blood vessel enlarges, allowing, white blood cells, nutrients, enzymes, and, antibodies into the harmed region to enable wound healing process to complete. At this point, this is when an injured person will start experiencing the physical impacts of the injury. Those physical impacts are heat, redness, swelling, and, pain.

Proliferation

The second stage is proliferation, in this stage, the wounds start to renovate with new healthy granulation tissue. The combination of the extracellular matrix and collagen forms the composition of a new membrane that enables the generation of a new network of blood vessels to substitute the injured ones. According to the AWMA, the color of the wound is a sign of the health of the injury. For instance, pinkish or reddish color suggests it is healthy, while a darker tissue represents an infection or shortage in supply of blood to the damage.

Maturation

It is the last stage to wound healing process. It happens after the wound has healed and it takes at least two years. In the course of this stage, the dermal tissues are repaired to improve their tensile strength and replacement of non-fibroblasts by function ones occur.

Daisy skin tear wound is in the first stage of the wound healing process. Because she experiences different pain when she is resting which increases with any movement. Caley, Martins, and, O'Toole (2015) claims that is it only in inflammation stage where a patient injured will experience physical impacts of the injury. Those physical impacts are heat, redness, swelling, and, pain. Moreover, from the picture of the leg ulcers, one can notice the wound appears reddish, and no clot has formed on it. Suggesting the injury is still in the process of supplying all the essential elements that will help in clot formation in the subsequent stage (Proliferation).

Discuss the holistic management of these two wounds (using the information in week 1)

Brown and Flanagan (2013) suggest that when conducting a wound assessment, practitioners are needed to evaluate the patient systematically and holistically, instead of concentrating on the wound. Therefore, apart from analysis patient's medical history, time should be set aside to assess to other factors that will that is underlying the problem, this ensures that the entire details essential for the development of a plan collected (Jun et al. 2016). According to Daisy's wound assessment report, the following are factors that affect the healing of her would:

Age

Daisy is 72yars old and falls in the older age group. Among factors that have a massive impact on the wound healing process is age. Age determines how long a wound will take to heal. As people age, they experience a physiological transformation that places one at a higher risk of a slow healing process. However, this relies on an individual's level of wellness, whereas there are biological changes, which are significantly out of control (Dhivya, Padma, & Santhini 2015). These uncontrollable changes may have an unfavorable effect on the wound healing process as described below. Daisy being the category of elderly stands the same risks due to age

Reduced skin elasticity

Skin loses resistance as people age, due to a deprivation of the elastic tissue and collagen fibers in the external dermal structure. Apart from these features providing flexibility and strength, they also assist masses in the recovery process and reinstate to its actual state. Due to the less elastic and supple nature of muscles, it is difficult with time to return to its original state. Suggesting that aged individuals such as Daisy are at a higher risk of damaging wound. Slower collagen replacement: moreover, reduction in elasticity of skin decrease collagen found in the body. Collagen plays a significant role in the development of cellular and renewal of tissue within the layers of the dermis, the lower the level of collagen the slower the healing process.

Diabetes

Flach and Czech (2015) urge that originate when a body is unable to generate or use insulin. Insulin role is the body is to enable body turn glucose into energy. For Daisy being diabetic her body usually finds it hard to metabolize glucose, causing sugar level in the body to rise, affects the ability of a body to heal wounds in the following ways.

High blood sugar levels

The primary factor that accelerates quick healing on a wound is blood sugar level. According to Flach and Czech (2015), when the blood sugar level is higher than required sugar level, it blocks nutrients and cut oxygen supply from strengthening cells, hence hinder immune system from operating effectively elevating soreness of cells, consequently, slowing down the wound healing process.

Poor circulation

Besides, individuals with diabetes have a higher chance of obtaining peripheral vascular disease. Peripheral vascular disease (PVD) is a blood circulation illness, which causes the blood vessels outside of the heart and brain to contract, block, or seizure (American Heart Association 2015). The disease affects the ability of red blood cells to move swiftly through the vessel. A higher blood sugar level upsurges the thickness of blood, causing heavy blood flow, thus reduces the wound healing process...