Best Practices for Wound Care

Treating Skin Tears in Elderly Clients


When skin tears occur, especially in elderly individuals, it is crucial to choose wound care products that optimise healing and minimise further damage to fragile skin. The ageing process affects the skin, leading to thinning of the epidermis, loss of collagen and elastin, and decreased activity of sweat and sebaceous glands, making older individuals more prone to skin tears (1)(2).

Skin tears result from various mechanical forces and require careful management to ensure optimal healing and prevent complications. Historically, basic island dressings and skin closure strips were commonly used, but evidence now suggests that this approach may not be optimal (3)(4)(5).

Importance of Following Best Practice Guidelines

Prevention is key, but when a skin tear occurs, it is vital to follow current best practice guidelines for treatment3. The International Skin Tear Advisory Panel (ISTAP) best practice recommendations (2018) emphasise initial treatment goals, including controlling bleeding, cleansing and debriding the wound, managing infection and inflammation, considering moisture balance and exudate management, and monitoring wound edges for closure(5).

Choosing the Right Dressings for Skin Tears

Selecting the ideal dressing for managing skin tears requires meeting several criteria, as outlined by ISTAP(5):

  • Control bleeding
  • Be easy to apply and remove
  • Avoid causing trauma on removal
  • Provide a protective anti-shear barrier
  • Optimise the physiological healing environment (e.g., moisture, bacterial balance, temperature, pH)
  • Be flexible and mould to contours
  • Secure, but not aggressive, retention
  • Offer extended wear time
  • Optimise quality of life and cosmetic factors
  • Be non-toxic
  • Be cost-effective

Silicone Foam Dressings

One highly recommended option after initial treatment is the use of silicone foam dressings, offering several benefits:

  1. Gentle Adhesion: Silicone foam dressings adhere gently to the skin without sticking to the wound bed, reducing pain and trauma during dressing changes(4).
  2. Maintains Moist Environment: These dressings help keep the wound moist, promoting healing and reducing scarring(4).
  3. Reduces Risk of Maceration: Designed to manage exudate effectively, silicone foam dressings prevent maceration of surrounding skin, reducing the need for frequent dressing changes(3)(4).
  4. Protection from Contaminants: Acting as a waterproof barrier, they reduce the risk of infection from external contaminants(4).
  5. Comfort and Flexibility: Silicone foam dressings are flexible and conform to the body’s contours, providing comfort and accommodating movement(5).

By considering these factors and following best practice guidelines, healthcare professionals can effectively treat and manage skin tears in elderly patients, promoting optimal wound healing and preventing future occurrences.

Surgical House stocks a range of leading wound care supplies including Medstock’s Silicone Foam Dressings. Click on the image above to explore entire range available from Surgical House.

Surgical House can also arrange wound care education and product training with a Medstock Clinical Educator. Please contact Serge Belardo for more information.

Content for this article was supplied by a Medstock Nurse Educator.

References

  1. Holmes RF, Davidson MW, Thompson BJ, Kelechi TJ (2013). "Skin tears: care and management of the older adult at home." Home Healthcare Nurse, 31(2): 90-101.
  2. Moncrieff G, Van Onselen J, Young T (2015). "The role of emollients in maintaining skin integrity." Wounds UK, 11(1): 68-74.
  3. LeBlanc K, Baranoski S, Christensen D et al (2016). "The art of dressing selection: a consensus statement on skin tears and best practice." Advances in Skin & Wound Care, 29(1): 32-46.
  4. Wounds UK (2012). "Care of the older person’s skin: Best practice statement (2nd edition)." (Accessed 7/6/24).
  5. ISTAP (2018). "Best Practice Recommendations for the Prevention and Management of Skin Tears in Aged Skin." Advances in Skin & Wound Care, 31(3): 50-64.

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