Pg. 54-59 5 minute read
Skin tears are traumatic wounds caused by mechanical forces, such as a blunt injury. They are defined as traumatic wounds occurring principally on the upper limbs as a result of friction alone or shearing and friction forces, which separate the epidermis from the dermis (partial thickness wounds) or which separate both the epidermis and the dermis from underlying structures (full thickness wounds) (Serra et al., 2018). Importantly, skin tears are preventable with the implementation of a risk-reduction programme, which includes twicedaily skin moisturisation. Although they are common - especially in individuals with vulnerable skin, their prevalence is underestimated. They are often misdiagnosed and have a high risk of developing into complex, chronic wounds (LeBlanc et al., 2019; Stephen-Haynes, 2023).
Although they are common, especially in individuals with vulnerable skin, skin tears are preventable with the implementation of a risk-reduction programme, which includes twice-daily skin moisturisation.
Preterm and newborn infants are particularly at risk of developing skin tears. The youngest children have underdeveloped skin, and their decreased epidermal-to-dermal cohesion, deficient stratum corneum, impaired thermoregulation, body surface/weight ratio that is nearly five times greater than an adult, and on top of that, their still immature immune system plays a role.
They can be seen in older adults, disabled populations and neonates, as well as in public hospital inpatients and residents of aged care facilities. In the elderly, physiological and pathological skin changes occur: the older skin has less collagen, less elastin or fatty tissue, especially in the papery skin, with decreased elasticity and shrinkage of subcutaneous tissue that causes wrinkles and emerging folds. The skin also has a decreased sebaceous gland function and sweat gland activity which causes the skin to dry out (xerosis), becoming more fragile.
Skin tears may often occur when health care providers handle patients or at the removal of surgical tapes or dressings, which apply external forces to the skin surface. Patients and their families may play an important role in prevention strategies, and professional caregivers should be adopt correct techniques during care procedures and skin care practices in order to avoid causing skin tears as much as possible. Also twice-daily skin moisturisation may help the skin condition in general (Serra et al., 2018; LeBlanc et al., 2019).
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