How to Treat Skin Tears

Skin tears are a very common wound care complication among older patients. Often caused by medical adhesive (tape) removal and/or common bumps or falls, they can lead to infection, scarring and, most of all, very acute pain. Whether in a facility or home care situation, the preeminent concern should be preventing skin tears at all costs. 

Unfortunately there are times where precautions fall short, and skin tears occur. What then? For patients and/or caretakers, it is important to treat these injuries properly. Read on to learn more about skin tears, and some products and procedures to help them heal. 

What is a skin tear?

A skin tear is an acute, traumatic injury in which the top layer (or layers) of skin is ripped away by a mechanical force, exposing the raw dermal layer beneath. This force is often caused by improper removal of adhesive tape or dressings, but can also be related to wheelchair injuries or accidental falls, among other causes. The vast majority of skin tears occur in the limbs, with a higher occurrence in the arms than the legs.

Skin tear risk factors

Older adults are by far the most vulnerable to these types of injuries. As the skin ages, the epidermis becomes more fragile due to a natural decrease in proteins like collagen and elastin. Various chronic or critical illnesses can accelerate these effects, regardless of age. All these factors can lead to a top layer of skin that is progressively more delicate and easily bruised. 

Unfortunately, these types of injuries are often incorrectly considered minor by patients or lay caregivers. As a result skin tears are often underreported, potentially leading to serious complications and unnecessary suffering.  

Treating a skin tear

When a skin tear occurs it is important to seek medical attention immediately. If left alone, or merely covered with basic gauze and tape, this type of injury is likely to result in complications including infections, cellulitis and/or potential sepsis. 

After thoroughly cleaning the wound and applying pressure and elevation to control bleeding, a medical professional will assess the state of the torn-away skin layer. Generally called a “skin flap,” this leftover skin is vital to the healing process. If still attached, it should not be removed under any circumstances.

Assessing the skin flap

The condition of the skin flap will determine the course of treatment. Generally speaking, the more torn-away skin that remains, the better the chance of complication-free healing. Clinicians divide skin flap status into three major types:

• Type 1: A fully intact skin flap that can be repositioned to cover the wound bed
• Type 2: Partially intact flap that cannot fully cover the wound bed
• Type 3: Total flap loss/fully exposed wound bed

Dressing the wound

Type 3 skin tears, the worst case scenario, will often be the most difficult to heal. A highly absorbent foam dressing like Mepilex Border Flex is recommended to cover these wounds. The Mepilex has an extremely gentle, easily removed, silicone-based adhesive which will help guard against infection while absorbing exudate. For less-exuding wounds, Mepilex Border Flex Lite may be sufficient. 

For Type 1 and Type 2 skin tears, the road to recovery is likely shorter. Because some or all of the shorn skin is still attached, it can be used as a natural bandage of sorts. In these cases, the skin flap is stretched and flattened to cover some or all of the wound bed. Next, a thin wound contact layer should be applied to keep the skin flap in place. Mepitel One is particularly recommended because of its Safetac adhesive technology, which allows for less painful dressing changes. 

Mepitel One is also ideal for this application because it may remain in place for up to 14 days, allowing for undisturbed healing during that time. Thin and flexible, it will easily conform to body contours. Also, the dressing is transparent, which allows for wound inspections without removal. 

We hope…

…this overview has been informative. For further medical questions and advice, always consult a medical professional. For product questions, Medical Monks has help available over the phone, email or LiveChat. 

SOURCES
– https://journals.lww.com/homehealthcarenurseonline/fulltext/2013/02000.aspx
– https://www.woundsource.com/blog/skin-tears-causes-prevention-and-treatment
– https://www.independentnurse.co.uk/clinical-article/63411/