Background Skin tears are common acute wounds found among aging populations and most commonly occur over the extremities. Along with increased age, risk factors include general health, mobility and skin condition. The ageing of the world’s population means that the burden of skin tears will continue to increase; therefore, a focus on awareness, prevention and evidence-informed wound management is imperative.

Aim To present a collaborative case study report of a patient in the community setting with a Type 1 skin tear.

Method This case report includes the patient (Leslie) as a co-author, to bring the experience of the person in her own words to the forefront in her journey towards healing in a community setting.

Results Leslie was unsure of how to care for her skin tear and felt frustrated by the variety of instructions and inconsistent approaches to her skin tear management. Decisions around her care were made without attention to her involvement. Leslie’s own words describe her experiences in the care of this initial acute wound that became hard-to-heal, but eventually closed.

Conclusion This case study captures the impact of hard-to-heal skin tears on the individual and identifies gaps and opportunities in wound care provision. Clinicians can reflect on their care delivery models to ensure that they provide patient-centred care.

Implications for clinical practice This case study may increase awareness among patients, providers, educators and policymakers of how we can better prevent and care for persons with skin tears and involve them in all aspects of care.

Skin tears are defined as a break in the skin greater than 2cm, also known as cuts, lacerations, grazes or skin tears. Skin tears can occur in many different scenarios, such as a mechanical fall or incidental shear or friction and are most common in the elderly population.² The correct dressing choice is required to address coagulation status, infection risk, wound product wastage, pain and quality of life management for the resident. Sussman and Ryan (2019, p. 11)⁹ issued a statement to the Royal Commission into Aged Care Quality and Safety Royal Commission on behalf of Wounds Australia (2019) and noted that ‘The major risks of the use of inappropriate dressings are: delayed healing, wound deterioration, potential infection, pain and stress to the consumer. The impact on cost of treatment of using inappropriate products is significant’.

There are various products in place at present in the aged care sector to manage skins tears. Currently, these options require the skilled nurse to use an aseptic technique and a combination of various products, as well as a dressing pack, to address the complexity of the aging skin. This study evaluated the introduction of a First Responder Skin Tear Wound Management Pack (STWMP). The primary aim of the eight-week project, applied across four aged care sites, was to evaluate the implementation of a first responder STWMP in which any health care worker could apply the correct regime, decreasing the risk of progression of a skin tear to a chronic or complex wound.

The results showed a reduction in skin tear time, therefore an increased rate of healing and reduction in staff time, all creating a reduction in the burden of disease that skin tears have in the aged care sector. In addition, it highlighted some design features and early data to inform further research into the impact of pre-education and socialisation of the first responder STWMP in practice. The first responder STWMP clearly has the potential to promote best and early practices for all residents’ skin in a multidisciplinary team with a resident-centred approach.

Background Skin tears are acute injuries caused by the separation of the skin layers due to shear forces, friction or blunt trauma and are quite common. A crucial role in reducing the occurrence of skin tears and their severity lies in the promotion of skin health and the prevention of skin lesions, especially in individuals with sensitive skin.

Aim To find measures for the prevention and treatment of skin tears that patients can take in the community.

Review methods Four electronic databases were searched: PubMed, Embase, CINAHL (EBSCO interface) and Web of Science. The search string combined index terms and words related to skin tears, prevention and management. Studies reporting on the prevention and management of skin tears in adults were included. Articles published before 2011 were excluded. The quality of articles was assessed using the Critical Appraisal Skills Programme (2019) for systematic reviews, the SIGN methodology checklist for randomised controlled trials and the AGREE II tool for consensus documents and best practice standards. Eight studies were included.

Results Articles reviewed provided numerous prevention and treatment measures: emollient therapy, bathing regimen, protective clothing, nutrition and hydration, polypharmacy, mobility and education.

Conclusion We found a limited body of knowledge, with studies contributing to best practices, prevention and management strategies and the prevalence of skin tears in older, community-dwelling adults.

Implications for clinical practice Elderly people living at home, especially those at high risk for skin tears, should be encouraged to participate in the prevention and treatment of skin tears.

Background Skin tears are common in many care settings. Clinicians’ practices show a lack of knowledge on skin tear classification, prevention and treatment; documentation problems; and a lack of uniform language.

Aim The aim of this study is to investigate nurses’ perceptions, opinions, knowledge and practices on the prevention and management of skin tears in French-speaking Switzerland.

Method A survey was conducted among nurses and wound care specialists in Western Switzerland. Data were collected between 17 November and 14 December 2020 and analysed using descriptive statistical and thematic analyses.

Result A total of 117 nurses and wound care specialists participated in this survey; 89% described skin tears as common. Skin tear definitions (18%, n=15), classification systems (7%, n=6) and risk factors were not well known. Prevention measures were often non-existent (87%, n=82). A standard of care was infrequent (5%, n=6). Pain (76%, n=70), delayed healing (75%, n=70) and frequent dressing changes (72%, n=67) were common issues and complications. Education on dressing choices (89%, n=80); prevention measures (88%, n=79); and aged skin issues (86%, n=77), were identified as important teaching topics.

Conclusion The results contribute to our understanding of wound care specialists’ clinical judgment on preventing and managing skin tears in French-speaking Switzerland and highlight the importance of wound care education.

Implication for clinical practice To enhance nurses’ knowledge of wound care and ensure evidence-based practices, we recommend implementing standard, unified wound curricula for nurses at the undergraduate and post-graduate levels, based on the existing European curricula.

Background Ageing populations are at risk of skin tears due to changes in their skin.  Real-world data sets offer the ability to see current prevalence rates and practice changes to understand the size of the problem and glean practice insights.

Aim Leveraging Swift Medical’s big data set, a point-prevalence analysis was conducted over five years on skin tears in skilled nursing facilities (SNF) in North America, to better understand time to heal and explore the frequency of commonly used treatments and cleansing solutions for skin tears.

Methods This descriptive prevalence study used a subset of an anonymised big dataset from participating SNFs across North America. Data from 188,675 skin tears in patients aged 20 years of age or older from 2017–2021 were included. Relative prevalence compared to other wounds was analysed, and healing times based on skin tear classification and frequency of primary, secondary and cleansing solutions were reported.

Results More than 1.5 million wounds were included in this dataset, and skin tears accounted for 10.3–12.8% of skin tears in SNFs over the five-year period. The prevalence of skin tears increased with age. Median healing time ranged from 15–27 days, based on skin tear classification.

Conclusion Big data sets can provide insight into current wound prevalence and practice patterns. The high prevalence of skin tears highlights the need for standardised tools to assess risk and prevent skin tears, and to educate clinicians on classifying and treating skin tears effectively.

Background A skin tear is a defined as a wound caused by shear, friction or the result of blunt force. Injury-related Type 1 skin tears are more frequent in elderly patients, due to their more fragile and vulnerable skin.

Aim We compared a cyanoacrylate liquid skin protectant (CLSP) to skin closure strips (SCS) for Type 1 skin tear closure and healing in 14 elderly patients.

Methods Eight patients received CLSP alone, three patients received SCS alone and three others received SCS followed by CLSP.

Results For the eight patients treated with CLSP alone, the skin tear flaps annealed almost immediately and were completely closed within 1–3 days. All skin tears were healed within 1–2 weeks of CLSP application. By contrast, for the three cases that were treated with SCS alone, the skin tears remained open for as long as 10 days and required 3–4 weeks to heal. This resulted in prolonged bleeding, delayed skin tear wound healing, re-opening of the skin tear, additional homecare nursing and dressing care. The three patients treated first with SCS followed by CLSP experienced a delay in wound healing; however, when the SCS were removed and CLSP was applied at 1–3 days, wound healing still occurred within 1–2 weeks of the CLSP application.

Conclusions A CLSP alone is an effective treatment for injury-related Type I skin tears in elderly patients.

Implications for clinical practice The use of CLSP decreased the time and costs required for skin tear wound care and reduced the time to wound healing.

Skin tears (STs) are acute traumatic wounds caused by friction, shearing and/or blunt force that result in the rupture of skin layers, the dermis and/or epidermis. Among the main causes are wheelchair injuries (mechanical trauma) and transfers, falls and the removal of adhesives. This study aimed to investigate nurses’ current knowledge of the identification, classification, prevention, assessment and management of STs. The intention was to identify knowledge gaps to design an appropriate education programme for improving skills in the assessment, prevention and identification of STs; to increase awareness; and improve and facilitate existing knowledge of STs. The ST knowledge assessment instrument OASES was used, as this is a validated tool. A pilot phase determined whether the language and content of the tool were understood, and to verify the time required to complete the survey. For the main study, a questionnaire was emailed to 139 registered nurses working in a geriatric rehabilitation hospital located in Malta. In all, 101 responses were gathered over a four-week period (73.4% response rate). The overall results indicated knowledge deficits across the identification, prevention, assessment and management domains of STs. Results for domains related to aetiology, classification and observation, and specific patient groups showed a good level of knowledge, but risk assessment, prevention and treatment showed poor knowledge. Immediate recommendations include the adoption of best practice guidelines and protocols to improve nurses’ awareness and knowledge of STs. This will be facilitated by the development of an education programme to address the knowledge gaps identified.

This paper describes the process a wound care team used to develop a protocol to standardise the care of skin tears in an orthopaedic specialty hospital.

The aims of the project were to: 1) find a classification tool to implement standardisation and 2) develop and implement a treatment algorithm and guidelines according to current evidence.

A protocol and algorithm were developed to deal with skin tears in a standardised format. Knowledge increased 36% after an educational intervention targeting skin tear aetiology and implementation of the newly developed protocol.