Definition of skin tears

A skin tear is a wound caused by shear, friction and/or blunt force resulting in separation of skin layers.

There are three main types of skin tear:

Type 1 - no skin loss

Linear or flap tear that can be repositioned to cover wound.

Type 2 – Partial flap loss

Flap cannot be repositioned to cover the wound bed

Type 3 - Total flap loss

Entire wound bed is exposed.

Treatment

When treating a skin tear, first control bleeding, try to bring edges together (if possible), minimise pain and discomfort, and prevent infection.  Gently cleanse the wound, irrigate with saline to remove any debris or dirt.

After cleansing the wound, protect periwound with Cavilon No Sting Barrier Film. Keep the surrounding skin hydrated by applying a suitable emollient to intact skin.

Treatment for types 1 and 2

• Avoid suturing, staples, wound closure strips, gauze, Inadine, tapes and
  adherent dressings.
• Bring edges of the wound gently together; easing the flap back in place using sterile gloved finger or forceps. For flaps that are difficult to align, use a moistened non-woven swab.
• Apply Mepilex Border Comfort. Before applying, draw an arrow on the dressing. The arrow should start from the edge of the skin flap that is still attached to aid removal of dressing.
• Ensure the dressing is removed in the same direction as the skin flap or tear. Add the date the dressing was applied.
• Protect fragile skin with tubular bandage or long-sleeved clothing.

Treatment for type 3

• Avoid gauze, Inadine, tapes and adherent dressings.
• Apply Mepilex Border Comfort. Before applying, add the date
  the dressing was applied.
• Protect fragile skin with tubular bandage or long-sleeved clothing.
• Refer to appropriate healthcare professional for advice and support if require

Other things to consider

• If the skin tear is on the lower leg complete a lower limb assessment and ABPI and consider compression.
• If in a setting you are unable to do this refer to appropriate local service
• Surgical review and intervention may be needed for complex skin tears with full thickness skin injury, significant bleeding,
  and haematoma formation; please contact the patient’s GP or call 999 for excessive bleeding.
• Monitor for any signs of infection.