Home > Caregivers, Dressing, Hygeine/grooming, Safety, Strategies > Care and Treatment of Skin Tears

Care and Treatment of Skin Tears

Image courtesy arztsamui @ http://www.freedigitalphotos.netThis post is a follow-up to one I wrote the other day, Skin Care for the Aging.  I wanted to speak a little more to a particular type of skin problem that is often found in individuals who are elderly and/or very frail for one reason or another.  That is the problem of skin tears, or an injury that occurs when the top layer of skin is broken or otherwise separated from the tissue beneath it.

As we age, our skin can become very fragile.  This can be compounded when the skin is poorly nourished, or dry and brittle, and if the person has lost a lot of weight.  When this happens, the skin can become damaged easily, caused by even the simplest bump or scrape.  The most common sites for skin tears are the arms and lower legs.  Such damage to the skin can lead to further injury and/or infection, and should be treated as soon as they are noticed.

People who are dependent on others for care are at particular risk for skin tears.  These can happen when the person is being showered or bathed, dressed, or transferred from one place to another.  When devices such as lifts and hoists are used to transfer a person, or they are placed into something with sharp angles and hard metal surfaces (like a wheelchair), the risk of tearing the skin is increased.

Other problems that can increase the risk of skin tears include confusion leading to wandering, poor vision, and decreased safety awareness that can cause a person to bump into furniture or other obstacles.  Decreased recognition of pain and injury, as well as short-term memory loss that can result in a lack of care for skin tears when they do occur, are also important considerations with these individuals.

One way to protect the skin from damage due to tears is to make sure the arms and legs are covered by clothing or soft fabric protectors designed for the purpose.  As I have worked in various nursing homes, it is not unusual to see some of the residents wearing sleeve-like garments made of T-shirt like fabric, to protect their lower arms from bumps and bruises.  These can usually be obtained from a supplier of medical equipment and specialized clothing.  I am also a voracious knitter, and have seen many patterns for what are essentially long gloves without fingers, worn either for warmth or as a fashion statement.  If the individual is concerned about appearance, it might be possible to have someone make some of these “arm warmers” for him/her.  One caution here, though.  If a garment such as this is used, it should be loose enough to allow for full movement of the limbs.

Other things that can be done to protect the individual from skin tears include:

1.  Keep the skin well hydrated.  Apply moisturizer after a bath or a shower.

2.  Don’t rub the skin when drying it.  Pat it dry, instead.

3.  Be sure to drink plenty of fluids.

4.  Ensure that dependent arms and legs are supported with pillows.

5.  Put cushioned protectors on sharp corners of furniture, similar to those you might use when a small child is around.

6.  Don’t grab a person suddenly by the arms.

7.  Be careful how you pull clothing over the arms and legs.

8.  Put padding on the arms and leg pieces of wheelchairs.

9.  If the person has siderails on the bed, be sure to cushion them so that the person cannot bump into them or get their arms and legs caught between them.

10.  Make sure that the room has adequate lighting.

11.  Avoid transferring the person unsafely.  If you’re not sure, ask a home health nurse to show you how to do it properly.

If the person you are caring for does get a skin tear, consider the following methods of caring for it:

1.  Wash your hands well and wear gloves if possible, to prevent infection.

2.  Clean the wound well with normal saline, or under gently running water.

3.  Place a sterile non-stick dressing over the wound.  Be sure to use something that is not going to adhere to the skin around it, causing further damage upon removal.

4.  If the wound is severe, consider consulting a medical professional.

5.  Keep an eye on the wound for any signs of redness or swelling, pain, or discharge, that may indicate possible infection.

  1. May 6, 2013 at 10:59 AM

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