Preventing Skin Tears

A skin tear is a specific type of laceration that most often affects older patients. In a skin tear, friction alone-or shearing force plus friction-separates layers of skin. A partial-thickness wound occurs if the epidermis separates from the dermis; a full-thickness wound occurs if the epidermis and dermis separate from underlying tissue.

With some effort and education of the staff, the patient's risk can be substantially reduced. Practitioners can help prevent skin tears by:

* using proper lifting, positioning, transferring, and turning techniques to reduce or eliminate friction or shear

* padding support surfaces where risk is greatest, such as bed rails and limb supports on a wheelchair

* using pillows or cushions to support the patient's arms and legs

* telling the patient to add protection by wearing long-sleeved shirts and long pants whenever possible

* using nonadhering dressings or those with minimal adherence, such as paper tape, and to use a skin barrier wipe before applying dressings

* removing tape cautiously using the push-pull technique

* using wraps, such as stockinette or soft gauze, to protect areas of skin where the risk of tearing is high

* telling the patient to avoid sudden or brusque movements that can pull the skin and possibly cause a skin tear

* applying skin lotion twice a day to areas at risk.

Source: Wound Care made Incredibly Easy!! Springhouse, PA: Lippincott Williams & Wilkins; 2003.