1.1 The anatomy and physiology of the skin in relation to skin breakdown and the development of pressure sores. The skin is the largest organ of the body and it acts as a waterproof protector for all the internal organs and it consist of four distinct layers: The epidermis, the basement membrane zone, the dermis and the subcutaneous layer.
The epidermis which is the outer layer and is a protective multilayered self renewing structure which varies in thickness depending on which part of the body it covers under this the dermis, this is a layer of connective tissue which provides the skins elasticity and strength, it also contains sensory nerve endings, blood and lymph vessels, sebaceous and sweat glands. Under this layer is the subcutaneous fat layer; this separates the skin from the underlying bone and muscle with rich blood supply it also serves as an insulator and energy store. Pressure ulcers develop when a large amount of pressure is applied to an area of skin over a short period of time. Or, they can occur when less force is applied but over a period of time. The extra pressure disrupts the flow of blood through the skin. Without a blood supply the affected area of the skin becomes starved of oxygen and nutrients. It begins to breakdown, leading to the formation of ulcers.
1.2 Pressure sites of the body the common areas, which are at, risk of pressure ulcers involve bony areas such as heels, hips, elbow and back. Body includes the tail bone (sacrum) hipbone areas, and the ankle and heel. Less common sites include the elbow, spine, ribs and back of the head and ears.
1.3 Factors which might put an individual at risk of skin breakdown and pressure sores are reduced mobility or immobility, acute illness, sensory impairment, level of consciousness, poor nutrition, poor vascularity, anemia, extreme of age, weight, drugs or medication, severe infection, chronic or terminal illness, dehydration and a previous history