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The integument comprises the skin together with its appendages. These include hair and hair follicles, sebaceous and sweat glands, and nails. The skin covers the entire body and is the largest organ of the body. It has an array of functions. These include acting as a barrier to physical, biological and chemical agents, as well as to ultraviolet (UV) radiation. Skin barrier function also acts to control body hydration. Other functions include: sensory and thermoregulatory roles, vitamin D synthesis, immune surveillance, excretion of wastes through sweat glands, socio-sexual communication and reproduction, by virtue of its appearance and smell (e.g. hormones and pheromones). Skin is divided into glabrous (covering the palms of the hands and soles of the feet) and hairy skin. The skin comprises of two layers, the outermost epidermis and the innermost layer, the dermis. A wound is a breach in the barrier that distinguishes an organism from its environment. In wound healing we can consider four phases – coagulation, inflammation, fibroplasia, and remodeling; four types – fetal, adult, acute, and chronic; four ages – young, plateau, regressing, and atrophic; and two systems of healing – epidermal and dermal. The single most important impact on wound healing by man has been the early closure of wounds, by apposition with sutures in incisional wounds, and skin replacement in excisional wounds. The end-point of skin wound healing is re-epithelialization or scarring. There are varied types of scarring which include hypertrophic and keloid scarring. |
