In performing an integumentary assessment, how do definitions of intact and not intact skin apply to documenting intentional breaks in the skin (eg, surgical incisions)?

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Bottom line:  There is no clear documentation in the literature designating intentional breaks in the skin, due to incisions, chest tubes, etc., as specifically not intact skin.

Summary:

CDC Key Terms
http://www.cdc.gov/nhsn/PDFs/HSPmanual/7_HPS_keyTerms.pdf
Non-intact skin is defined as “areas of the skin that have been opened by cuts, abrasions, dermatitis, chapped skin, etc.”

Larson E, et al. Prevalence and correlates of skin damage on the hands of nurses. Heart Lung. 1997 Sep-Oct;26(5):404-412.
This epidemiologic study of skin damage on nurses’ hands describes specifications for non-intact skin. Table II (p. 406) describes completely intact skin as that without abrasions or fissures.

Several nursing blogs include discussions of the ambiguity of how to document skin intactness for patients with surgical incisions.

Reviewed 4/25/2014 ldt

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