Wound Wise: Flora gone wild! Superficial candidal infections
Kelly Drumright BS, BSN, RN, CCRN-CMC, CSC
Stephanie Julkenbeck BSN, RN
Chris Judd BSN, RN

Nursing Made Incredibly Easy!
February 2013 
Volume 11  Number 1
Pages 18 - 22
  PDF Version Available!

When healthy and intact, our skin protects us against various assaults from our surrounding environment. Let's think of our skin as a coat of armor that guards us from harmful UV rays, chemical irritants, physical trauma, and various pathogenic microorganisms. The outer layer of our skin is where the main antimicrobial defenses are located, fending off danger by maintaining an acidic surface pH, hosting resident flora that helps keep certain pathogens in check, and triggering the immune system in response to intruders. The skin also functions to regulate our temperature, prevent fluid loss, and alert us to danger by sensing if something is too hot or cold, sharp or painful.Breaks in the integrity of our skin or mucous membranes provide an opportunity for unwelcome visitors to penetrate our armor. Some areas of the skin are more prone to invasion than others, especially moist areas such as the axillae, perineum, and sweat glands, and between the toes, fingers, or skin folds. Extended exposure to moisture weakens the protective barrier of our skin and can increase the skin's pH, raising the risk of microbial colonization.Additional factors that can contribute to the weakening of the skin, making us more vulnerable, include: * physical damage (such as cuts, scrapes, friction, and surgical incisions) * burns * exposure to chemicals (such as gastrointestinal [GI] contents, alkaline soaps, alcohol, and feces) * infections (bacterial, fungal, or viral) * moisture or maceration (from sweat, urine, moisture-donating wound dressings, and tight-fitting clothing that can trap moisture against the body) * radiation * malnutrition * vascular damage (venous, arterial, or neuropathic) * immunosuppression * systemic illness (such as diabetes, malignancies, hypothyroidism, and Cushing syndrome) * medications (such as glucocorticoids, immunosuppressive drugs, broad-spectrum antibiotics, and chemotherapeutic agents).Over 100 species of the yeast-like fungus known as Candida exist, but

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