The document is a presentation on skin management that was presented to Miss Nadia Azfar. It covers the introduction of skin, definition and stages of bedsores, symptoms and causes, wound healing, use of the Braden scale to assess pressure ulcer risk, and nursing interventions to prevent bedsores. The skin is the largest organ and functions in thermoregulation, protection, metabolism, and sensation. Bedsores, also known as pressure ulcers, develop due to reduced blood supply and oxygen to skin tissues from prolonged pressure. They are classified into four stages based on severity, from mildly reddened skin to deep wounds affecting muscles and bones. Preventing bedsores involves regular repositioning, skin inspection, nutrition, lifestyle changes

1. SKIN MANAGEMENT PRESENTATION
PRESENTED TO : MISS NADIA AZFAR
PRESENTED BY:
❑ ABDULRAZZAK
❑ ABDUL JABBAR
2/20/2021
❑ FARAZ MAZHAR
❑ ARSHAD ALI
❑ AHSAN ULLAH
❑ SHAMSHAD AHMED
❑ MURAD AHMED
FUNDAMENTAL OF NURSING SEMESTER 1 GBSN RUFAIDA
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2. OBJECTIVES OF PRESENTATION
□ Introduction of the skin.
□ Define bedsores.
□ Enlist the symptoms of bedsores.
□ Explain the causes of bedsores.
□ Describe the stages of bedsore.
□ Explain wound healing.
□ How to use Braden scale?
□ Nursing interventions to prevent the bedsores.
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3. INTRODUCTION OF THE SKIN
□ The skin is the largest organ in the body
□ The skin functions in thermoregulation, protection, metabolic functions and
sensation.
□ The skin is divided into two main regions, the epidermis, and the dermis
□ Skin accounts for total 16-20% of the body weight which is double then the
weight of the brain.
□ The skin acts as a sense organ because the epidermis, dermis, and the
hypodermis contain specialized sensory nerve structures that detect touch,
surface temperature, and pain.
□ The subcutaneous fats under the skin is not considered as a part of skin.
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4. WHAT ARE BEDSORES
□ Bed sores are also known as pressure ulcers and decubitus
ulcers.
□ Bed sores are caused by the death of tissues of the skin due
to deficiency or reduction of blood supply, oxygen and
nutrients.
□ Bedsores most often develop on skin that covers bony areas of
the body, such as the heels, ankles, hips and tailbone.
□ The waste products of metabolism accumulates in the cell and
the tissues consequently dies.
□ Prolonged unrelieved pressure also damages the small blood
vessels.
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6. SYMPTOMS OF BEDSORES
□ Red skin that gets worse over the time.
□ The area forms a blister then an open sore.
□ Swollen skin especially over the bony area.
□ The beginning signs of a pressure sore include
Skin that's red either abnormally warm or cool to the touch
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7. CAUSES OF PRESSURE ULCERS.
□ Pressure ulcers are caused by the pressure against the skin
that inhibits an adequate supply of blood to skin and tissues.
□ Pressure formed by a hard surface – such as a bed or
wheelchair.
□ Pressure that is placed on the skin through involuntary muscle
movements – such as muscle spasms.
□ Moisture – which can break down the outer layer of
the skin (epidermis)
□ Friction occurs when the skin rubs against clothing or bedding.
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8. POINTS OF PRESSURE ULCERS

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11. STAGES OF BEDSORE
Bedsores are classified into stages according to wound severity there are
mainly four types stages of bedsores
❏ Stage 1 (mild stage)
❏ Stage 2 (treatable stage)
❏ Stage 3 (critical stage)
❏ Stage 4 (most severe stage)
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12. STAGE 1 BED SORE
 Skin is unbroken but shows a pink or reddened area
 May look like a mild sunburn
 Skin may be tender, itchy or painful.
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13. STAGE 2 BEDSORES
 Skin is red, swollen and painful
 Blisters may be present
 Upper layers of skin begin to die
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14. STAGE 3 BEDSORES
 Ulcer has broken through the skin and wound extends down to
deeper layers of skin tissue
 Wound is very much prone to infection
 This stage is critical stage and should be immediately cared.
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15. STAGE 4 BEDSORES
These sores are the most serious. Some may even affect your muscles and
ligaments and can cause deadly complications
The sore is deep and big. Skin has turned black and shows signs of infection pus or
drainage. You may be able to see tendons, muscles, and bone. Tell your doctor right
away. These wounds need immediate attention, and you may need surgery.
A Stage 4 pressure sore is not healed easily.
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17. WOUND HEALING
 Healing is a quality of living tissue is also referred to as
regeneration (renewal) of tissues.
 Healing can be considered in terms of types of healing, having to
do with the primary care provider’s decision on whether to allow
the wound to seal itself or to purposefully close the wound, and
phases of healing, which refer to the steps in the body’s natural
processes of tissue repair.
 The phases are the same for all wounds, but the rate and extent
of healing depends on factors such as the type of healing, the
location and size of the wound, and the health of the client
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18. BRADEN SCALE FOR SKIN ULCERS
The Braden Scale for Predicting Pressure Ulcer Risk, is a tool
that was developed in 1987 by Barbara Braden and Nancy
Bergstrom. The purpose of the scale is to help health
professionals, especially nurses, assess a patient's risk of
developing a pressure ulcer.
The Braden scale assesses a patient's risk of developing a
pressure ulcer by examining six criteria
□ Sensory perception
□ Moisture
□ Mobility
□ Activity
□ Nutrition
□ Friction and shear
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19. This combines for a possible total of 23 points, with a higher
score meaning a lower risk of developing a pressure ulcer and
vice versa. A score of 23 means there is no risk for developing
a pressure ulcer while the lowest possible score of 6 points
represents the severest risk for developing a pressure ulcer.
The Braden Scale assessment score scale.
□ Very High Risk: Total Score 9 or less
□ High Risk: Total Score 10-12
□ Moderate Risk: Total Score 13-14
□ Mild Risk: Total Score 15-18
□ No Risk: Total Score 19-23
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21. PREVENTIONS OF BED SORES
PATIENT POSITIONING
Changing patient position is very important to prevent bed sores even
during the night if patient is bed-ridden.
SKIN INSPECTION
Daily skin inspection for pressure sores are an integral part of
prevention.
NUTRITION
A Healthy diet is important to prevent skin breakdown and aid wound
healing adequate hydration is also important to maintain skin integrity.
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22. LIFESTYLE CHANGES
It is very important to maintain fluid and salt intakes, quit
smoking and drugs,managing stress and exercising daily.
NURSE RESPONSIBILITIES
 Make sure that the bed sheet is smooth and wrinkled
free with no friction
 Make specific turning and repositioning schedule
 Device use for lateral positions
 Pressure redistribution support surfaces
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23. REFERENCES
1.UNIT #36 FUNDAMENTAL OF NURSING CONCEPTS, PRACTICE AND
PROCESS 8TH EDITION BY KOZIER, BARBARA, GLENORA ERB,
AUDREY BERMAN AND SHIRLEE SNYDER.
2.SLIDESHARE.NET/INTRODUCTIONTOTHESKINPRESENTATION BY
DR.VIJAYAKAR
3. SKIN MANAGEMENT PRESENTATION BY MISS NADIA AZFAR
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