The what, who, why and how of skin tears in the community and care homes
Skin tears frequently occur following a simple trauma, but can become chronic and complex wounds if inappropriately assessed and managed, particularly if on the lower leg. It is important for health professionals, patients and carers to understand the principles of prevention and the importance of fundamental skin care. Identifying those at risk can help with the development of a specific preventive approach. This article offers a brief overview of the International Skin Tear Advisory Panel (ISTAP) best practice recommendations for holistic strategies to promote and maintain skin integrity.
A skin tear is defined as a traumatic wound caused by mechanical forces or by the removal of adhesives. Skin tears have a high risk of becoming a complex hard-to-heal wound. It is suggested that skin tear prevalence rates are equal to or greater than those of pressure ulcers (LeBlanc et al, 2018).
Older people can experience a variety of skin problems including skin tears, leg ulcers, pressure ulcers and oedema. The National Wound Care Strategy Programme (NWCSP) (https://tinyurl.com/rqh5kfw) includes a lower limb strategy, and draft recommendations are now available (NWCSP, 2020) The NWCSP aims to reduce unwarranted variation in care of leg wounds, improve outcomes and safety and optimise the patient experience.
A leg ulcer is defined as a long-lasting (hard-to-heal) sore that takes more than 2 weeks to heal (NHS website, 2020). Lower limb ulcers are estimated to affect 1.5% of the population, or about 730 000 patients (Guest et al, 2015). The NWCSP (2020) lower limb recommendations outline a pathway of care based on a rapid diagnosis and appropriate therapeutic interventions and escalation to the relevant clinical specialist for those requiring more complex care, including vascular assessment and the application of compression therapy.
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