Skin Tears Prevention and Management
A skin tear results from friction, shearing or injury to the skin.
As we age changes in the skin increase our risk of skin tears. Older adults commonly experience skin tears on the arms, hands and lower legs.
Skin tears often occur while transferring, using a wheelchair or after a fall. Skin tears can be difficult to prevent and treat.
What is a skin tear?
A skin tear occurs when the epidermis (top layer) of the skin becomes separated from the underlying layer (dermis).
Skin can become very fragile with age. Even the simplest movement, bump or knock can cause damage.
Skin tears often occur in people who are dependent on others for showering, dressing, and transferring. The use of lifting equipment and assistive devices increases the risk of skin tears.
People with confusion, poor vision and problems wandering can often bump into furniture or not recognize hazardous objects. Skin tears will often be sustained on the arms, lower legs or hands.
Complications from skin tears include infection. See your doctor or community nurse if skin shows any signs of inflammation or the skin appears painful, swollen and hot to touch.
Preventing Skin Tears
Residents living in nursing home facilities are at greater risk of developing skin tears. Improper handling and lifting techniques often contribute to skin tears. Aged care staff must take caution when assisting residents with activities of daily living.
Keeping residents well hydrated and moisturizing the skin daily can help keep skin supple and prevent damage. Wearing protective sleeves and bandages can also help prevent skin tears from trauma.
- Keep skin hydrated by moisturizing daily after a shower
- Pat skin dry, do not rub
- Increase fluid intake
- Wear long sleeves or pants
- Support dependent legs or arms with pillows
- Cushion sharp furniture corners
- Avoid grabbing a person by the arms
- Avoid pulling clothing over elbows or lower calves
- Use sheepskin padding on wheelchair arms and legs
- Place bed protectors over bed rails to avoid limbs getting caught between rails
- Ensure environment is well lit
- Dress skin tears with a non-adherent (non stick) dressing and take off under the shower
Avoid transferring or lifting a person by dragging them. Ask a community nurse to show you how to safely move a person without causing friction and shearing of the skin.
How can I protect the skin from damage?
Arm protectors and leg protectors are garments designed to fit around the arms or legs providing protection against injury, relieving pressure between bony areas and keeping limbs warm.
Some arm and leg protectors are lightly padded and fit snugly over the limbs with Velcro fastening. Others fit like a thick sock over the limb. Avoid any product that constricts the limb. Ask a community nurse or doctor for advice if you cannot get good clinical advice from a supplier.
Arm and leg protectors can be worn under clothes, in bed and wheelchairs or over dressings.
Dressing a Skin Tear
- Wash hands thoroughly and wear gloves if possible
- Clean the wound with normal saline or under a shower
- Apply a sterile non-stick dressing
- Secure the dressing and protect the wound with first aid tape or a bandage
- For complicated dressings see a doctor or community nurse
- Observe the wound for signs of infection including swelling, pain, ooze and redness
With due care and observation, many skin tears can be avoided. If a skin tear does occur, gently clean and dress the area as soon as possible. Seek medical attention if necessary.
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