Ouch! That’s got to hurt. I’m talking about skin tears. An often painful, but generally preventable health issue, skin tears are distressing injuries that usually occur due to friction, shearing or blunt trauma to the skin. It may also appear when fragile skin is damaged against a hard or sharp object. They are seen by many as minor injuries. Nevertheless, they can become rather important and complicated wounds that oftentimes lead to infection. They may also compromise the body’s blood vessels which can increase malaise and mortality especially among the elderly and persons with pre-existing conditions.
Those more susceptible to skin tears are infants and more frequently in the elderly. Skin can become more fragile with age with even the simplest bumps and knocks can cause notable tissue damage. A skin tear may appear on any part of the body. They commonly emerge on the extremities, particularly on both the upper and the lower limbs, and are prevalent at the back portion of hands just above the wrist. Skin tears on infants with undeveloped skin are partially blamed on the use of adherent tapes, like those in diapers, on gadget trauma and it also always coexist with diaper rash.
Questions to ask to determine if you are at risk of Skin Tears:
- How old are you and what is your gender?
- Do you have a history of skin tears?
- Is your skin dry and delicate?
- Do you use medications which cause the skin to thin out like steroids?
- Are you prone to skin bruising and discoloration?
If ever the tear is extensive or associated with a full injury, very significant bleeding or the presence of hematomas, a surgical option may be needed. The main goals of managing skin tears are to sustain the skin flap and safeguard the surrounding tissue, to prevent the stretching of the skin around the wound and lastly, to minimize the uncertainty of infection and further aggravation of the injury. The fundamental rule of moist wound healing is advocated in the following guidelines:
- · First Control the bleeding
Steps to take include the cleaning of the wound and applying pressure and elevating the area affected. The use of water or warm saline to flush and clean the wound and the removal of any residual hematoma and foreign debris is also recommended. Finish off by gently patting and drying the wound and also the surrounding skin to minimize the worsening of the injury.
- · Approximation of the skin flap
If the skin flap is loose and moveable, gently ease it back into place using a cotton tip. If the flap is difficult to align or is already hardened, try using a moistened cotton swab and rehydrate the wound for about 15 minutes before easing it back into place.
- · Application of the dressing
Allow sufficient breathing room between each strip to enable drainage and to also avoid strain over flexure sites. The use of hypo allergenic paper and silicone tapes are encouraged. Tissue glue may also be used to stabilize the flap.
- Evaluation and Assessment of the wound
Monitoring for escalation in the wound and observation for signs of infection is vital. Utmost care should be taken in the cleaning of the wound as pain can hinder the healing process and upset the quality of life. If pain is present, analgesic options may be considered.
We are aware of the effects that ageing has on the skin. Prevention of skin tears is important as we are all at risk. Simple things as the wearing of long sleeves, pants and socks for the elderly, while also keeping adequate nutrition and hydration do wonders in the prevention of skin tears. Keeping skin well lubricated by the application of moisturizers also minimizes our risk. Skin tears are very annoying if ever you had one. Now we don’t want that to happen, don’t we?