Integumentary Aging

Question 1

What are some normal signs of integumentary aging?

Answer 1

• Thin, less elastic skin (thinner dermis, loss of sub-q fat, decreased fibroblasts)
• Decreased Langerhans (50% by age 80 which alters immunity) and Melanocytes (8-20% every 10 yrs until age 30)
• blood vessels become thinner and more fragile
• decreased oil/sweat gland activity
• Decreased ability to thermo-regulate and increased pain threshold
• Impaired skin barrier and more susceptible to shearing and separation of skin layers

Question 2

What are some general prevention guidelines for integumentary compromise?

Answer 2

• Proper nutrition and hydration (decreases risk of integument issues)
• Environment (~40% humidity)
• Control of co-morbidities
• skin care

Question 3

What factors for bathing should be changed with compromised integumentary?

Answer 3

• Avoid bars of soaps and use gentle, moisturizing liquid soaps
• soft cloths and cooler water temps
• moisturizing after bathing (within 3 minutes to trap moisture)
• don’t over bathe (10mins daily or twice weekly)

Question 4

What is the ISTAP?

Answer 4

A skin tear tool kit

Question 5

How do skin tears occur?

Answer 5

• turning/lifting/transfers/falls
• sliding down in bed w/ raised HOB
• Blunt trauma/WC injuries (leg rests)
• 80% on UE and hands

Question 6

What is the proper treatment for skin tears?

Answer 6

• approximate attached edges if possible (realign skin flaps)
• non-adherent dressings (foam, calcium alignate, adaptic, telfa, “Safetac” dressings, hydrogel, etc.)
• protect the peri-wound