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Skin Tear
Occurs when friction and shearing forces cause tissue layers to slide across each other breaking blood vessels.
Skin Tears: A Review of the Evidence to Support Prevention and Treatment
Physiological changes that occur as part of the aging process put the elderly at risk for developing skin tears. Lack of consistent care in the management of skin tears in the authors? community sparked a literature search to determine best evidence for the management of skin tears. Medline® and Cochrane Library databases were searched for studies and systematic reviews on skin tear prevention and treatment. The literature suggested that the greatest number of skin tears occurs among the elderly (65 years and older). Factors reported to be associated with the occurrence of skin tears in addition to age include immobility and a history of skin tears. In the absence of systematic risk factor research, clinicians continue to report that all variables that may be associated with these wounds must be considered when assessing the elderly. Several small studies suggest that most skin tears occur on the extremities and seasonal incidence variations also have been reported. Despite consistent sample-size limitations, the results of controlled clinical studies and case series consistently suggest that education and implementation of prevention protocols reduce the incidence of skin tears in extended care facilities by almost 50%. Studies to evaluate and compare the effectiveness and cost-effectiveness of skin tear treatments are limited but when appropriate care is provided most skin tears can be expected to heal after 7 to 21 days depending on the severity of the wound. A combination of skin protection, preventive measures, and treatments that facilitate moist wound healing appear to be most effective. Risk factor and epidemiological studies as well as research to validate the existing skin tear classification system and improve clinician ability to provide evidence-based risk assessments, preventive care, and treatment are needed. KEYWORDS: skin tear, skin laceration, xerosis, elderly skin, traumatic wounds
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No-Rinse, One-Step Bed Bath: The Effects on the Occurrence of Skin Tears in a Long-Term Care Setting
As the population ages, the occurrence of skin tears becomes a common concern for those providing care. Skin tears are painful and increase the cost of caring for residents in long-term care facilities. Records of 29 bed-bound residents at a 72-bed, long-term care facility were reviewed to ascertain the effects of changing from using soap and water to a no-rinse formula for bathing on the occurrence of skin tears. The effect of the bathing change on nursing practice, patient care outcomes, and cost of patient care also were examined. When the new bath procedure was used, the number of skin tears decreased from 13 in the first month to one in the fourth month, affecting both caregiver time and cost. The observed reduction in the occurrence of skin tears was estimated to result in an annual decrease in cost $2,446.
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Preventing Skin Tears in a Nursing and Rehabilitation Center: An Interdisciplinary Effort
Skin tears are painful, traumatic wounds that result from the separation of the epidermis from the dermis. To assess the clinical effectiveness of a preventive skin care protocol, 13-month retrospective pre-intervention data collection followed by 15-month post-intervention skin tear incidence data collection was conducted among all patients in a 209-bed urban nursing and rehabilitation center. The preventive skin care strategies implemented ? staff education, skin sleeves and padded side rails for high-risk patients, gentle skin cleansers, and lotion ? were selected by facility staff members and the multidisciplinary skin team. Nosocomial skin tear data were obtained by reviewing incident reports. Following implementation of the prevention protocols, the number of skin tears changed from a mean of 18.7 to a mean of 8.73 per month (P <0.001). The average monthly reduction in nosocomial skin tears was projected to reduce the dressing and labor costs of managing these wounds an average of $1,698 per month ($18,168.60 annually). The results of this study confirm previously reported research suggesting that the effects of implementing a comprehensive skin care protocol can persist, reducing the incidence of nosocomial skin tears and their associated risks and costs. Prospective cost-effectiveness studies to confirm these findings are needed.
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Evaluation of a Once-Daily Moisturizer Used to Treat Xerosis in Long-Term Care Patients
The pruritic, erythemic, dry, scaly, cracked, or fissured skin characteristic of xerosis is a result of the loss of natural moisturization factors and barrier abilities, as well as epidermal water loss. To determine if a new 24-hour moisturizer provides clinical benefit by reducing dry skin, scratching, and erythema, a 5-day prospective study was conducted that involved 16 residents (6 men, 10 women) with end-stage renal disease (average age 76 years) in a long-term care facility unit with an 18% prevalence of xerosis. Extent of xerosis was measured by evaluating each of the symptoms (dry scaly skin, erythema, and pruritus) using a four-point ordinal scale where 0 = absence of symptom and 3 = severe symptom. Photographs and patient comments were obtained at the time of the assessments on Day 1 (before the first product application) and on Day 5 (after four once-daily applications). One resident was discharged before the day 5 evaluation. Resulting data from the 15 patients completing the study were analyzed using a paired-sign test. Reduction in dry, scaly skin, erythema, and pruritus were statistically significant (P < 0.001, P < 0.001, and P = 0.016, respectively). Implementing a 24-hour moisturizer was found to significantly decrease symptoms of xerosis. Additional study to further validate use of the product in this and other settings where patients experience dry, red, itchy skin is warranted. KEYWORDS: dry skin, xerosis, moisturization, skin tears, pressure ulcers
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An Innovative Solution for Skin Tears: A Case Study
Characteristics of the ideal skin tear dressing include the ability to: * maintain a moist wound environment * manage a wide range of wound drainage * protect the wound and periwound skin from trauma upon dressing removal * conform to the wound * be cut without impacting the integrity ...
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SAWC 2004 Abstract Preview
Methods: A prospective, comparative study was conducted over a 4-year period at our Wound Treatment Center. Results: In our study, 88 of the 99 patients (89%) had wound healing. Studies that have examined patients?
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New Educational Brochures on the Treatment of Abrasions, Bruises, Cuts, and Skin Tears for the Publicand Healthcare Providers
Admittedly, access to this education is limited. Topics to be addressed include: • Treatment of minor wounds • Care of the skin • Pressure ulcers • Diabetic/neuropathic feet The first committee began work on brochures to ...
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April 2003 Letters to the Editor
The treatment provides one or more of the following effects: * Increased oxygen delivery to injured tissues * Infection control * Blood vessel formation (neovascularization) * Preservation of damaged tissues * Elimination of toxic gasses. Laura...
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Effectiveness of a Non-Petrolatum Emollient Cream in Pediatric Care
s Hospital, Louisville, Ky; and Darcy Helder, BS, Coloplast Skin Health Division, Marietta, Ga Adapted from a poster presented at the Symposium on Advanced Wound Care, San Antonio, Tex, April 30–May 3, 2006 The skin of premature neonates may be overly susceptible to skin tears due to decreased skin elasticity. Three case studies were used as part of the product evaluation to determine the efficacy of the...
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The Antimicrobial Benefits of Silver and the Relevance of Microlattice Technology
More than 90% of all wounds have a bioburden. Assessing the Wound Environment The wound environment can be divided into three large zones. Through a process called silver cascade, moisture from the wound or skin enters the dressing.
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