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|Tube Feeding Tips: Skin Care|
Take Care of Your Skin
If the skin could talk, I think it would sing one of Elvis Presley’s favorite lines: “Don’t be cruel”!
The average adult has 3,000 square inches of skin. Its main function is to protect from harsh chemicals and bacterial and viral organisms, as well as the sun. The skin also prevents dehydration, regulates temperature, and allows sensory communication.
Layers of the Skin
The skin is divided into three distinct layers: epidermis, dermis, and hypodermis (subcutaneous layer). The epidermis is the outermost layer and is avascular, meaning there are no blood vessels in this layer as it is nourished by the dermis. This layer is renewed approximately every two months. Its thickness depends on where it is on the body.
The second layer, the dermis, is the thickest layer; it is very vascular. It contains many important structures, including: blood vessels, hair follicles, fat cells, nerve endings, sweat glands, sebaceous glands, and connective tissue.
The third layer, the hypodermis or subcutaneous layer, contains fat cells, lymph vessels, and larger blood vessels that protect the muscles and bones.
Protecting Your Skin
One of the biggest challenges is to keep the skin clean, dry, and free from harm, especially when the skin has been broken by a tube or a stoma. In the case of a tube, leakage and tube mobility are factors. In the case of a stoma, leakage, an improper fitting flange, harsh drainage, or unprotected peristomal skin are risks. However, there are steps you can follow to promote skin health.
The most important issue in maintaining skin health is to hydrate and nourish the skin. Adequate proteins, minerals, vitamins, and calories keep the skin supple and well fed. Keep your skin clean and dry but not dried out. Soaps that have a high acidity to them will remove the protective acid mantle. If your skin is dry, use a moisturizer; conversely, if your skin is wet, dry it.
Examine your skin each day. Check all around the tube site or the stoma site, especially underneath by using a mirror. Stabilize the tube by using a holder or a tube stabilizer. Clean the area with warm water and dry well.
For stoma care: clean the peristomal skin with warm water only. Dry the skin well. Some may use a barrier wipe before placing the wafer (flange).
We need to protect the skin at all costs; it is time well spent keeping away complications.
—Betty Brady, RN, CWOCN
LifelineLetter, July/August 2010
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Oley exhibit at A.S.P.E.N.'s Clinical Nutrition Week