Question

The elimination patterns of our patients are very important to know as we continue to assess and do our care plans. How can impaired elimination affect the integumentary system?

Answer 1

Intact and healthy skin is a natural barrier against skin infection and bacterial growth. Impaired elimination can be either urinary or faecal incontinence. Incontinence can result in close contact of skin with urinary or faecal matters. Prolonged contact with these matters can cause softening of the skin, which makes it more susceptible to friction damage and increases the risk of a pressure sore.

The urea in the urine can change the skin texture and encourage the bacteria to grow. When the urea breakdown in the presence of faecal ureases, it increases the pH. This is because ammonia is released, which promotes the activity of faecal enzymes such s protease and lipase.. tHese enzymes increases the hydration of the skin and make the skin more suspectable for bile salts penetration and cause skin irritation. In the case of faecal incontinence, harmful enzymes present in the faeces cause the breakdown of skin and enhances bacterial and fungal growth. The PH of the skin gets alters with close contact with these matters and results in reddening and breakdown of the skin.

Sometimes dermatitis.exposure to the bacteria in urine or stool results in burning and itching, especially in genital, abdomen or thighs and chronic exposure to urine and stool develops dermatitis by increasing the PH.