Know your skin- your body’s largest organ
The skin is the largest organ of the human body and acts as a natural protective covering. By acting as a protective barrier from UV radiation and extremes of temperature, it also contains sensory perceptions like touch; pressure; temperature; pain etc. Skin also controls the loss of fluids and acts as a thermoregulator. It creates a barrier between the external environment and the internal organs.
Understanding how the skin can function in these many ways starts with understanding the structure of the 3 layers of skin – the epidermis, dermis, and subcutaneous tissue.
The skin also includes the structures that grow out of the skin, plus a couple of glands:
- Hair: The protein keratin forms hair. Hair has an inner layer (the cortex), which contains pigments that give it colour, and an outer layer (the cuticle). It grows out of follicles, which are little pockets of epidermis in the dermis. The shape of the follicle determines whether hair is curly or straight. Each follicle contains a hair bulb from which the hair develops. Arrector pili muscles connect the hair follicle to the skin.
- Nails: Keratin shows up in the form of plates found on ends of the fingers and toes. Underneath each nail is a nail bed with a root at the proximal end (closer to the rest of the body).
- Sebaceous glands: These glands are connected to the hair follicles. They produce sebum, which is an oily substance that helps keeps the hair flexible.
- Sweat glands: Sweat glands are coiled tubular glands found in most of the skin. The secretory portion (the part that secretes the sweat) of each gland lies in the fascia with a duct that runs up to the surface of the skin.
Wound- Types and Management
Wounds occur when the skin is broken or damaged because of injury. Causes of injury may be the result of mechanical, chemical, electrical or thermal sources. The skin can be damaged in a variety of ways depending upon the mechanism of injury.
There are different types of wounds -
- Contusion – bruising or hemorrhage. Caused by a blow from something blunt
- Abrasion – caused by skin being scraped along a hard surface
- Incision – clean cut/surgical. Skin, soft tissues and muscle may be severed
- Laceration – Rough edges e.g. from teeth, claws, barbed wire.
- Puncture – small entry. May have some internal damage and can become infected
- Tear/Avulsion – skin and soft tissue partially or completely torn away
- Cavity – chronic, open wound
Wound care and its management:
Wounds like contusion, abrasion, incision, laceration can be managed at home.
- First, wash and disinfect the wound to remove all dirt and debris.
- Use direct pressure and elevation to control bleeding and swelling.
- When wrapping the wound, always use a sterile dressing or bandage
Chronic wounds are those that take time to heal or are hard to heal. They, require medical supervision and attention. Leg ulcers, pressure ulcers, diabetic foot ulcers all falls under in this category. Chronic wound such as diabetic foot ulcer require immediate medical intervention, such wounds if ignored can lead to severity.
Surgical wounds are the incision or cuts made during a surgical procedure. The size of wound will vary depending on the type of surgical procedure done. Sometimes healthcare professionals close the wound by sutures, staples or using adhesive or may be left open to heal. Surgical wounds can be managed at home, but if there are any unexpected or serious symptoms consult your doctor immediately.
Burn wound- Care and Management
Burn is a skin damage in which many of affected cells die. You can get burned by heat, fire, radiation, sunlight, electricity, chemical or hot or cold water can be a cause of burn. Depending on the cause and severity of skin damage the treatment and healing time varies.
Burns, greater than 15% in an adult, greater than 10% in a child, or any burn occurring in the very young or elderly are serious.There are four degrees of burns:
- First-degree burns: Affects epidermis or only upper layer of skin. The burn site is red, non-blistered and may be painful.
- Second-degree burns: affects epidermis and part of the dermis layer of the skin. The burn site appears red, blistered and may be swollen and painful.
- Third-degree burns: destroys epidermis and dermis and may go into subcutaneous tissues. There is no sensation at the burn site since the nerve endings are destroyed. The burn site may appear white, leathery appearance.
- Fourth- degree burns: affects all the layers of skin and also damage the underlying bone muscles and tendons. There is no sensation at the burn site. Burn site appears black and dry.
How long does it take for burns to heal?
- First-degree burns usually heal in 3 to 7 days.
- Second-degree burns usually heal in 2 to 3 weeks.
- Third-degree burns usually take a very long time to heal.
- Fourth- degree burns usually do not heal, and in most cases amputation or excision is needed.
How burns are treated? Treatment of burns depends on the degree and severity. You must see a doctor if:
- A first or second degree burn covers an area larger than 2-3 inches in diameter.
- The affected body part is face, joint (such as knee or shoulder), hand, feet or genitals.
- The burn is third or fourth degree burn which requires immediate medical attention.
If you choose to treat your wound at home, hold the burned area under cold running water for at least 11-20 minutes or until the pain subsides, or immerse the burn in cold water to relieve the pain and swelling. Avoid using ice or extremely cold compresses because they can worsen the injury.
In the case of second, third and fourth degree burns to avoid infection and other complications, medical assistance is advised. The healthcare professional will determine the degree of burn and proper treatment which includes removal of debris, dead skin and blister, and use of suitable dressing.
It will be important to keep the burn wound clean while it’s healing.
You are an important part of infection prevention
We and our loved ones go to healthcare facility when we’re sick, with expectation to get better. But did you know that people can get infected while being treated in a healthcare facility.
Thousands of people die every day around the world due to hospital acquired infections, which can be prevented.
In infection prevention everyone plays important role from healthcare professionals, families of the patients to patients themselves, both in and out of the healthcare setup.
Hands are the main pathways to spread germs; you can spread or catch the germs casually by touching another person or already infected objects or surfaces.
Hand hygiene is a key of infection prevention, it’s necessary to perform hand hygiene practice at right moment and in a right way.
For an effective and proper hand hygiene use soap (medicated or non-medicated) and water, hand wash and hand rubs (an antimicrobial containing gel or liquid which doesn’t require soap and rinsing by water, it gets evaporate easily after rubbing so, saves the time).
Please note for visibly dirty hands it is recommended to wash your hand with plain water before using hand rub. If you do your part properly you can save yourself and your loved ones from infection because infection prevention is not only healthcare professionals’ job.When to perform hand hygiene:
- If you have any patient at home, clean your hand before and after touching patient and his belongings.
- After visiting the toilet
- Before and after handling food
- When the hands are visibly dirty
- After coughing or sneezing into your hands
There are 7 steps of hand hygiene suggested by WHO (world Health Organization), which are well known and well accepted but still need awareness.