References

Andrews H. The fundamentals of skin care. British Journal of Healthcare Assistants. 2013; 6:(6)285-290

Cowdell F, Jadotte Y, Errsser S. Hygiene and emollient interventions for maintaining skin integrity in older people in hospital and residential care settings. Protocol for Cochrane Systematic Review. 2014; https://doi.org/10.1002/14651858.CD011377

Patient comfort and end-of-life caret. Chapter 8 in: Royal Marsden Hospital Manual of Clinical Nursing Procedures, 9th edn, Professional Edition. In: Dougherty L, Lister S (eds). Chichester: John Wiley and Sons; 2015

Ersser S, Lattimer V, Surridge H, Brooke S. An analysis of the skin care patient mix attending a primary care-based nurse-led NHS Walk-in Centre. Br J Dermatol. 2005; 153:(5)992-996

Lichterfeld A, Hauss A, Surber C Evidence based skin care: A systematic literature review and the development of a basic skin care algorithm. J Wound Ostomy Continence Nurs. 2015; 42:(5)501-524

Moffatt C. Skin care management for patients with lymphoedema. Wound Essentials. 2006; 1:172-174

Mukhopadhyay P. Cleansers and their role in various dermatological disorders. Indian J Dermatol. 2011; 56:(1)2-6 https://doi.org/10.4103/0019-5154.77542

NHS website. Emollients. 2017. https://www.nhs.uk/conditions/emollients (accessed 4 June 2019)

Nowicki J, Siviour A. Best practice skin care management in lymphoedema. Wound Practice and Research. 2013; 21:(2)61-65

Penzer R, Ersser S. Principles of skin care.Chichester: Wiley; 2010

Penzer R, Finch M. Promoting healthy skin in older people. Nurs Stand. 2001; 15:(34)46-52 https://doi.org/10.7748/ns2001.05.15.34.46.c3025

Ronda L, Falce C. Skin care in older people. Primary Health Care. 2002; 12:(7)51-57

Snelling A, Saville T, Stevens D, Beggs C. Comparative evaluation of the hygienic efficacy of an ultra-rapid hand dryer vs conventional warm air hand dryers. J Appl Microbiol. 2011; 110:(1)19-36

Venus M, Waterman J, McNab I. Basic physiology of the skin. Surgery. 2011; 29:(10)471-474

Walters RM, Mao G, Gunn ET, Hornby S. Cleansing formulations that respect the skin barrier integrity. Dermatol Res Pract. 2012; 2012 https://doi.org/10.1155/2012/495917

Care of skin that is oedematous or at risk of oedema

13 June 2019
Focus
02 June 2019
Volume 28 · Issue 11

Oedema of any kind predisposes the skin to dryness as the skin becomes stretched and undernourished with reduced oil secretion. If prolonged stasis of tissue fluid occurs, the area of oedema becomes transformed into inelastic, fibrotic tissue with thickened skin in the epidermal layer. The skin loses its first-line immunity barrier to bacteria and any penetration of the skin can lead to infection and a worsening of the oedema (Nowicki and Siviour, 2013).

Where there is a risk of lymphoedema following treatment for cancer, or a risk of oedema due to reduced mobility, obesity, or venous disease, diligent daily care of the skin can maintain its integrity and reduce the risk of infection. The term ‘skin care’ refers to skin cleansing, drying and moisturising with the aim of retaining the barrier function of the skin (Moffatt, 2006).

The skin is the largest organ of the body and comprises three layers (Figure 1):

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