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WOUND CARE TODAY
2014,Vol 1, No 1
techniques following local
manual handling guidance, e.g.
when using lifting devices or
slide sheets. Bed sheets should
NEVER be used to move an
individual, as this can cause a
‘dragging’ effect on the skin and
strip the epidermis and dermal
layer (Beldon, 2006)
›
Where possible, reduce or
eliminate pressure, shear and
friction using pressure-relieving
devices and appropriate
positioning techniques
›
Encouraging patients to wear
appropriate footwear and
clothing to reduce the risk
of injury. For example, wearing
socks can protect the pretibial
leg area.
Holistic prevention
Clinicians should consider ways
in which the overall risk to the
individual can be minimised. This
may include optimising nutritional
status, encouraging movement
and mobility, frequent review of
medications and the maintenance of
the skin.
ONGOING MAINTENANCE
Identifying those at risk of skin
tears and implementing preventive
strategies will help to keep the skin
intact, as will making sure that
patients’ skin is well-hydrated by
maintaining their nutritional intake
and fluid balance.
Patients with dry skin on their
arms and legs will benefit from twice-
daily applications of an appropriate
moisturising cream (Hanson et al,
2005). It is important to:
›
Use pH-friendly soap (avoid
highly perfumed products) or
cleansing solutions
›
Control or contain moisture from
incontinence or other sources
›
Avoid/minimise the application
of adhesive tapes directly onto
the skin
›
Protect limbs and fragile skin
by using tubular or roll-on
bandages, long thick — but
not tight-fitting — socks, full-
length trousers, and long-sleeved
clothing.
CONCLUSION
The prevention of skin tears is an
important aspect of skin care in older
people and neonates. It is important
that older people with a skin tear are
treated promptly and appropriately
to prevent complications and
optimise healthcare resources.
An awareness of the anatomy of
the skin and the effects of ageing will
help clinicians identify those patients
at risk of developing skin tears.
It is also important for clinicians
to have a thorough knowledge of
skin tear management techniques,
as well as the patient’s medical co-
morbidities, social circumstances,
mobility, continence status and
psychological wellbeing.
A competent clinician should be
able to assess a patient who presents
with a skin tear, as well as agree a
plan of care, while more junior staff
and healthcare assistants are ideally
placed to assist with prevention.
REFERENCES
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Baranoski S (2003)
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R, Harding K. eds,
Trauma and Pain in
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Top tip:
Helping to prevent skin tears can
involve quite simple precautions,
such as ensuring that light
switches are easily reachable,
rugs and carpets are not overly
slippery, and that small furniture
such as chairs and night tables are
not cluttering walkways...
WCT
FOCUS ON SKIN TEARS
›
