The skin is an important organ and has a variety of functions, including:
• protection
• control of body temperature
• excretion of sweat and sebum
• sensations of touch, heat, cold, pain and pressure
• support.
Maintaining the integrity and cleanliness of the skin is therefore essential to the maintenance and promotion of health.
The skin is made up of three layers:
1 The epidermis or outer coating of the skin – cells on the surface are continually being rubbed off and replaced by new ones. Hairs and sweat glands form part of the epidermis, and the ducts of sebaceous glands pass through this layer.
2 The dermis is a thicker layer – it is tough and elastic and contains blood vessels, nerve fibres, lymph vessels, sweat and sebaceous glands.
3 The subcutaneous layer contains fat cells and provides heat regulation for the body.
The factors that may affect cleansing and dressing may be:
• physical arising from alterations in the structure or functions of the skin, motor or sensory deficits of the musculo-skeletal system, presence of wounds, drains, level of hearing, vision, shortness of breath
• psychological such as safety, self-esteem, personal space, self-image, privacy, motivation
• sociocultural, for example family influences, peers, groups, routines, societal standards, religious beliefs, gender
• environmental including facilities available, temperature, climate, time of day
• politico-economic, for example lack of finances, hot water, adequate resources and occupation.
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