Diabetic Skin Ulcer Anatomy
To better understand decubitus ulcer, it helps to understand the anatomy of the skin.
The skin contains three main layers:
- The superficial layer that makes up the surface of the skin
- It is composed of skin cells and can be divided into 5 layers based on cell type.
- The top layer of the epidermis, the stratum corneum, is made of dead, flat skin cells that shed about every 2 weeks.
- The thickness of the epidermis varies, according to location: it is very thick over the soles of the feet, and very thin over the ears.
- Lies beneath the epidermis
- Also varies in thickness depending on the location of the skin. It is .3 mm on the eyelid and 3.0 mm on the back.
- The dermis is composed of 2 layers that contain a connective tissue called collagen
- The dermis contains blood vessels, nerves, sweat glands, and hair follicles.
- The number of structures in the dermis varies, according to location.
- The dermis under the arms contains more sweat glands and hair follicles than the dermis on the back.
- Subcutaneous layer:
- Mainly fat and connective tissue.
- Contains blood vessels and nerves.
Continue to Diabetic Skin Ulcer
- Brem H, Tomic-Canic M, et al. Healing of elderly patients with diabetic foot ulcers, venous stasis ulcers, and pressure ulcers. Surg Technol Int. 2003;11:161-7. 
- Duimel-Peeters IG, Halfens RJ, Berger MP, Snoeckx LH. The effects of massage as a method to prevent pressure ulcers. A review of the literature. Ostomy Wound Manage. 2005 Apr;51(4):70-80. 
- Ratliff CR; WOCN. WOCN's evidence-based pressure ulcer guideline. Adv Skin Wound Care. 2005 May;18(4):204-8.