Q: What can we do better to prevent and treat skin tears?
A: A skin tear is a traumatic wound resulting from separation of the epidermis (top layer) from the dermis (underlying layer). The aging process causes older adults to be at high risk for skin tears.
With age, the skin becomes fragile, the outer layer of skin thins, and there is a decrease in pain perception. In addition, the skin becomes dry, accompanied by a loss of collagen and elastin fibers that may cause the skin to easily stretch.
A few measures to prevent skin tears include: moisturizing dry skin twice daily; no rubbing of skin — pat dry instead; and averting the use of taping directly to skin — use paper tape if necessary at all.
Also, you should use pad protectors over bedrails, wheelchair arms and leg supports. Protect extremities by wearing long sleeves or pants and use arm and leg protectors where appropriate. Avoidfriction when repositioning, transferring and lifting.
When tears do occur, you can use the Payne-Martin Classification, which was developed in the 1980s and consists of three categories: I — skin tear without tissue loss; II — skin tear with partial tissue loss; III — skin tear with complete tissue loss; epidermal flap is absent.
Don’t forget appropriate treatment protocols: Use normal saline or wound cleanser to gently clean the skin, and pat dry or allow the area to air dry.
Numerous products can be used to treat skin tears, such as skin sealants, petroleum-based products, other water- resistant products, self-adhesive foam and gauze wraps to avoid taping the skin.
Your wound care product provider(s) should make available additional product options and educational information to help educate your staff, as well as residents and their family members.
From the May 01, 2012 Issue of McKnight's Long-Term Care News
