Skin Damage Risks: Infection, Pain, Scarring, and Functional Impairment

Primary Risks of Skin Breakdown

Infection: Broken skin breaches the primary barrier. Bacteria (Staph, Strep), fungi, viruses enter → cellulitis, abscess, sepsis. Risk ↑ with diabetes, immunosuppression, vascular disease.
Pain: Exposed nerve endings; exacerbated by air, friction, dressing changes. Chronic wounds → neuropathic pain components.
Scarring: Abnormal collagen deposition → hypertrophic scars, keloids, contractures limiting ROM (especially over joints).
Loss of Function: Impaired sensation, thermoregulation, sweating, hair growth. Joint contractures from scar tissue.
Psychological Impact: Body image distress, social withdrawal, depression, PTSD (especially burns, disfiguring wounds).
Fluid/Electrolyte Loss: Large open wounds → evaporative losses, protein loss, hypothermia.

Pressure injury prevention: repositioning, support surfaces, skin inspection.
Moisture management: incontinence care, barrier creams.
Nutrition: Protein 1.25–1.5 g/kg, vitamins C/A, zinc.
Prompt wound care: Cleanse, debride, moisture-balance dressings, offloading.
Infection control: Aseptic technique, topical antimicrobials (silver, honey, PHMB) for bioburden; systemic antibiotics for spreading infection.

Skin integrity is a vital sign. Interprofessional teams (nursing, PT/OT, nutrition, wound specialists) reduce complications and improve healing.