Rehabilitation of skin
Human skin is the largest human organ of heterogeneous nature. It is composed of three layers: subcutaneous tissue, dermis and epidermis. It is covered in hair follicles which form small bumps on the surface and go deeper into dermis. Dermis also contains sebaceous and sweat glands which secrete sebum and sweat respectively.
Skin plays an important protective, defensive and thermoregulatory role. In response to diseases, dysfunctions or mechanical injuries skin reactions include: reddening, maceration, bruises, haematoma and wounds. The patient’s health status and the cause of the wound allow to predict the healing duration and provide information necessary for the selection of agents and dressings. The healing process also depends on the bacteria residing in the wound and the wound depth. It is a multi-stage process which must be individually planned and take into account numerous factors.
After any damage or injury, especially in the case of deep wounds, the skin needs rehabilitation, which also depends on the treatment stage. The skin recovery relies on the wound depth, duration and type and the healing process involves appropriate dressing as well as rehabilitation: so called skin immunisation, radiation, ozone treatment and hyperbaric chamber therapy.
Specialist wound care facilitates wound healing and controls scar tissue formation.
Wound categories in skin rehabilitation stages:
5 – the wound affects muscles to the bones and joints and it involves dry gangrene. It is vital to protect the wound with several-layered dressings and apply pressure relief around and on the wound. It is also extremely important to apply moisturisers and prevent new bed ulcers formation. If possible and patient’s condition permits it, bedside rehabilitation, oxygen therapy and radiation are recommended.
4 – the wound affects subcutaneous fat tissue up to the muscles which are not damaged. The wound is yellow, so called necrolysis (yellow or black). Specialists dressings and pressure relief around and on the wound are necessary. Other recommendations include: skin immunisation with skin oils e.g. ozone-based oils, hyperbaric chamber, oxygen therapy, skin radiation and individual rehabilitation (e.g. bedside rehabilitation or with rehabilitation tools).
3 – the wound affects epidermis and dermis, red granulation tissue can be seen in the wound bed. The dressings are applied for short so that the skin immunisation can be started and blood supply in the wound can be improved by massage. Phitotherapeutic baths and ionised salt baths can be implemented if the wound healing stage and patient’s health status are not contraindications. Pressure relief dressings should be used and radiation, ozone and hyperbaric therapies can be added. Everyday functioning shouldn’t be disturbed, however, the wound should not be pressed or overloaded.
2 – skin reddening which does not disappear and swelling which persists despite position change, minor exudate. Tissue granulation and epithelializationoccur. Multi-layered and pressure relief dressings as well as skin immunisationshould be applied. The wound should not hinder everyday functioning but it should be protected by appropriate footwear or pressure relief insoles.
1 – reddened skin without breaking its layers. The skin can be protected with greasing or moisturising creams, lotions or oils. One-layered dressing or pressure relief dressings can be considered. The choice of dressing materials e.g. Tegaderm protective film, are particularly important in patients who had to lie.
Post-surgery skin treatment towards prosthesis and therapy after healing bed ulcers, skin burns or skin grafts require specific procedures. This final element of healing process is of great significance as it prepares the skin for its growth, elasticity restoration and stretching.
Our specialists instruct each patient how to care about and rehabilitate their skin individually or with the help of their families.