The skin is the largest organ in the body, taking 15% of the body weight. One’s physical and emotional health can be ascertained by just looking at his/her skin (Eming, Martin, & Tomic-Canic, 2014). As we age, our skin undergoes a lot of changes. These changes compromise the health of the skin, leaving it more susceptible to damage (Stevens, et al., 2005). The dermo-epidermal junction flattens out, making the skin more vulnerable to shear forces and very fragile too. Health conditions associated with old age such as incontinence may also expose the skin to further damage (Eming, Martin, & Tomic-Canic, 2014). While the faeces and urine turn the skin pH alkaline, incontinence also demands that one cleans himself/herself more often. Doing so with traditional soaps further changes the skin pH to alkaline. This alteration in skin pH may institute a change in the skin’s normal bacterial flora, permitting colonization with more pathogenic bacteria (Eming, Martin, & Tomic-Canic, 2014). Proper evaluation and diagnosis are, hence, very crucial in the treatment and dressing of these skin wounds.

Elderly people often remain in either sitting or sleeping posture for quite a long time. This makes them vulnerable to pressure ulcers. Pressure ulcers is majorly caused by pressure in a part of the body or skin (Frykberg & Banks, 2015). Although pressure ulcers may occur in any part of the body subjected to prolonged pressure, it is more common in body parts with bony prominences such as the heel (Morton & Phillips, 2016). As the major cause of pressure ulcers is undue pressure on a part of the body, preventing it, therefore, requires the employment of methods that evenly distribute body pressure. Such methods include repositioning and turning of the patient at least once in every two hours (Frykberg & Banks, 2015). It is also vital to keep vulnerable areas such as the heels from undue pressure. This can be achieved by turning the patient sideways on a bed while keeping the legs afloat above the mattress by a pillow (Frykberg & Banks, 2015). Pressure can also be relieved from the body with the help of static and/or dynamic specialized support surfaces. Thee support surfaces help redistribute pressure on the skin.

Testing the wound, or wound drainage, can help determine if there is an infection. Both the culture and sensitivity of the wound must be tested. Once the drainage has been collected, it is cultured to see the bacteria present and the right antibiotics to treat the infection, hence determined (Stevens, et al., 2005). Skin moistening is another effective method in pressure ulcers prevention. Dry skin is more vulnerable to pressure ulcers, hence keeping the skin moisturized is important (Stevens, et al., 2005). However, heavy massaging while applying skin moisturizing lotions over bony prominences is not recommended as this may easily break the skin (Morton & Phillips, 2016).

Incontinence and perspiration puts the skin at risk of developing skin ulcers as they keep the skin wet. This can be addressed by improved incontinence care and applying protectant barrier creams to the patient’s skin (Morton & Phillips, 2016). Treatment and dressing of pressure ulcers wound depend on whether the wound is deep or superficial. Topical agents are, in most cases, sufficient for the treatment of superficial bacteria growth. Topical agents such as normal saline can be enough to keep a wound clean (Stevens, et al., 2005). Another method of treating pressure ulcers wounds it through the removal of necrotic tissue. Necrotic tissue halts the healing of wounds by acting as a medium for bacteria overgrowth and checking the development of the granulation tissue (Stevens, et al., 2005). Depending on the wound, necrotic tissue can be removed through one of the several ways of debridement.

Proper dressing of the wound is very critical in its healing. The treatment or dressing method adopted for a wound must maintain a proper moisture balance for that wound. Ideally, the dressing method adopted should be such that it increases moisture to wounds that are too dry and decreases moisture to wounds that are too wet (Frykberg & Banks, 2015). Should the wound be too dry, film, hydrocolloids, or hydrogel dressings can be used. However, should the wound be too wet, then calcium alginate, foam, or hydofiber dressings can be used.