What is a skin tear?
A Skin tear is caused by shearing and friction on the skin, often resulting from minor trauma. As skin ages, it loses elasticity, hydration, and collagen, making it thinner and more fragile. The bonds between the epidermal and dermal layers weaken, increasing the risk of separation under pressure. Skin tears are most common on the extremities—particularly the hands, arms, and legs—due to frequent exposure to external forces. However, they can occur anywhere on the body, especially in elderly or immobile individuals. Moisturising and wearing clothing that protects areas most at risk can help reduce the occurrence of skin tears.
Who is most at risk?
The most prevalent risk factors for skin tears are:
- Old Age
- Impaired Mobility
- Falls
- Previous Skin Tears
- Cognitive deficit/dementia
- Dependence in Transfers
How to prevent a Skin Tear?
Prevention of skin tears revolves around improving skin integrity and eliminating potential hazards.
- Moisturise: Keeping your skin well moisturised can significantly reduce the risk of skin tears, as dry skin is less elastic.
- Stay well hydrated: Our skin cells constantly renew and need a consistent water supply to maintain their structure.
- Wear protective clothing: If you have a history of skin tears on your arms or legs, wearing clothing that covers them can provide extra protection.
- Furniture and room layout: Remove or rearrange any objects or furniture that clutter high-traffic areas of your house, especially in bedrooms and around bathrooms.
- Bathe less often: Bathing too frequently can dry out the skin. Consider reducing showering to a few times a week during the cooler months.
Treatment
Depending on the size, location, and medical history, a skin tear may be managed at home with dressing products. However, if you have a significant medical history or have experienced skin tears before, it is strongly advised to consult your healthcare provider for proper assessment and care. Skin tears are particularly delicate injuries, and if you have reduced vision or hand dexterity, it’s crucial to seek assistance from a medical professional to ensure appropriate treatment and recovery.
Materials required:
- Luke-warm water or saline
- Clean towel or sterile gauze
- A dressing that covers the full wound – preferably a silicone-based dressing, as this is softer on the skin and is less likely to cause further damage to the skin or further tears during removal
Dressing a skin tear:
- Wash your hands and set out your dressing supplies next to you on a clean surface
- Control any active bleeding
- Use a clean towel or gauze dipped in warm water or saline and gently clean the wound and surrounding skin. Do not remove the skin flap!
- Using a fresh towel or gauze, gently dry the area.
- After drying the area, using the same gauze, slowly roll the flap back over the wound bed. Flatten the skin flap onto the wound bed. Ensure the flap is completely flattened on the wound bed as it may reconnect to the existing tissue and heal faster. A skin flap acts as a natural barrier to help protect the wound from infection.
- Cover the wound with a clean dressing.
- Avoid removing the dressing for 2-3 days to allow the wound time to heal before it is disrupted again.
- On review and dressing change of the skin tear, check for visual signs of infection.
signs and symptoms of infection
- Redness
- Warm to touch
- Swelling
- Increased pain
- Large amounts of exudate/ooze in comparison to the wound size or previous exudating level