Unit 334

Amy Butcher
Unit 334
Undertake tissue viability risk assessments

The skin is the body’s largest organ, creating a barrier between the outside environment and the internal organs. The skin has several important functions. Thickness of the skin will vary depending on the location on the body e.g. the skin on the face is thin, skin on the back is thick. There are two main layers of the skin, the epidermis and the dermis, these two layers of skin lye on a third layer called the subcutis.
The epidermis is a thin outer layer of skin containing no blood vessels and relying on the dermis for its nutrients.
The dermis is the second layer of skin, this is the thickest of all three layers of skin, the dermis provides structure to the skin. Most of the skins specialised structures will be found in the dermis including-blood vessels, lymph vessels, hair follicles and sweat glands.
The third layer of skin the subcutis is a layer of fat helping to conserve the body’s heat and protecting the organs inside the body.
The skin has many functions, these include:
Protecting the body from heat, sunlight, injury and infection
Helping to regulate body temperature
Helping to control fluid loss
Getting rid of substance via sweat glands
Storing water, fat and vitamin D
Pressure ulcers are caused by constant pressure being applied to a certain part of the body. The pressure will affect the blood supply to the affected area, without this constant blood supply tissue will eventually become damaged and die. The skin will no longer receive the white blood cells it needs to fight infection, when an ulcer develops it can become infected with bacteria.
When a person enters a care setting it is important that an assessment of their tissue viability is carried out. A change in the person’s condition may mean a change in their risk to pressure ulcers, when this occurs the person should be reassessed as soon as possible.
When assessing the skin you should look for the following:
Colour-Many blood vessels lie near the surface of the skin. Pigmentation in individuals will not hide changes in the skin’s underlying colouring lightly pigmented individuals, skin normally has a pink colour.
Temperature-Skin is normally warm to touch, the skins feels hot with fever, the skin feels cool in shock
Moisture-The skin would usually be dry, wet, moist or very dry skins is abnormal.
Pre-disposing factors which may cause risk of skin breakdown to worsen are:
Medication
Moisture to the skin

External factors which may cause risk of skin breakdown to worsen are:
Pressure
Straining to material around the area
Friction
The tissue viability risk assessment should be regularly treviewed and repeated as a persons condition can change quickly which could mean change to the risk of pressure ulcers.With regular reviewing theses changes can be seen quickly.
The tissue viability assessment tool or current review cycle may no longer be appropriate due to a persons health/mobility. e.g. If a person was mobile and suddenly becomes bed bound a new assessment will need to be done as the person will be at a higher risk of skin breakdown. If a persons health were to worsen the reviews may need to be domne at more regukar intervals thsn previous to this as again they will be at more risk of skin breakdown.