A descriptive cross‐sectional international study to explore current practices in the assessment, prevention and treatment of skin tears

LeBlanc, Kimberly; Baranoski, Sharon; Holloway, Samantha; Langemo, Diane; Regan, Mary C.

doi:10.1111/iwj.12203

Cited by 45 publications

(66 citation statements)

References 9 publications

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“…Skin tears can be found on all areas of the body and are particularly common on the extremities . Skin tears may be also very common in public hospital inpatients and residents of aged care facilities, with prevalence of up to 41% in these settings .…”

Section: Introductionmentioning

confidence: 99%

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Skin tears and risk factors assessment: a systematic review on evidence‐based medicine

Serra

Ielapi

Barbetta

et al. 2017

International Wound Journal

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Skin tears represent a common condition of traumatic wounds, which may be encountered in some categories of individuals at the extremes of age, such as infants and the elderly. Despite the high prevalence and cost of these lesions, there has been little investigation into the risk factors that lead to this condition. The aim of this review was to systematically evaluate the main risk factors involved in development of skin tears. We planned to include all the studies dealing with risk factors related to skin tears. Only publications in English were considered. We excluded all the studies that did not properly fit our research question and those with insufficient data. Of the 166 records found, 24 matched our inclusion criteria. After reading the full-text articles, we decided to exclude seven articles because of the following reasons: (1) not responding properly to our research questions and (2) insufficient data; the final set included 17 articles. From a literature search, we found the following main issues related to risk factors, which have been described in detail in this section: age-related skin changes, dehydration, malnutrition, sensory changes, mobility impairment, pharmacological therapies and mechanical factors related to skin care practices. Our findings clearly show that in frail populations (especially infant and elderly), the stratification risk, as a primary prevention strategy, is an effective tool in avoiding the development of chronic wounds. The development and the implementation of prevention strategies based on appropriate knowledge of the risk factors involved and the adoption of correct techniques during skin care practices could reduce or even avoid the onset of skin tears.

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Section: Introductionmentioning

confidence: 99%

“…Clinical management of skin tears can be difficult, and these wounds may also be associated with prolonged hospitalisation stays, increased health care costs and adverse impacts on patients' quality of life .…”

Section: Introductionmentioning

confidence: 99%

Skin tears and risk factors assessment: a systematic review on evidence‐based medicine

Serra

Ielapi

Barbetta

et al. 2017

International Wound Journal

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“…They also represent a considerable cost to the NHS. Existing measures to prevent skin tears have limited effectiveness in this susceptible population [27,28]. This pilot trial and any future definitive trial arising from it will focus on this important area of healthcare.…”

Section: Discussionmentioning

confidence: 99%

“…There are best practice guidelines for treatment and preventing infections and ulcers [26]. Prevention includes staff education, regular assessment, ensuring clothing does not rub, removing obstacles and moisturising the skin [9,27,28]. …”

Section: Introductionmentioning

confidence: 99%

Pilot randomised controlled trial of protective socks against usual care to reduce skin tears in high risk people “STOPCUTS”: study protocol

Powell

Hayward

Snelgrove

et al. 2015

Pilot Feasibility Stud

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BackgroundSkin tears are traumatic injuries occurring mostly on the extremities due to shearing and friction forces that separate the epidermis and the dermis from underlying tissues. They are common and occur mostly in older adults and those taking medications that compromise skin integrity. Pretibial skin tears can develop into leg ulcers, which require lengthy, expensive treatment to heal. Traumatic injuries are the second most common type of wounds after pressure ulcers in care homes and are the commonest reason for older adults to require the attention of a community nurse. Common causes of skin tear injuries are bumping into furniture and other obstacles, using mobility aids, transfer to/from wheelchairs, getting in and out of bed and falls. No effective preventative measures currently exist but knee-length, protective socks are now available that contain impact-resistant Kevlar fibres (of the type used in stab-proof vests) and cushioning layers underneath.Methods/designIn this pilot parallel group, randomised controlled trial, 90 people at risk of skin-tear injury will be randomised with equal allocation to receive the intervention or usual care. They will be recruited from care homes and from the community via general practices and a research volunteer database. Pilot outcomes include recruitment, eligibility, attrition, ascertainment of injuries and completion of outcome measures. Acceptability of the intervention and of study participation will be explored using semi-structured interviews. The proposed primary outcome for the future definitive trial is skin tear-free days. Secondary outcomes are skin tear severity, health status, specific skin-tears quality of life, capability and fear of falling, measured at baseline and the end of the study and in the event of a skin tear.DiscussionThe results of this study will be used to inform the development and design of a future randomised controlled trial to assess the effectiveness and cost-effectiveness of a unique and innovative approach to skin tear prevention.Approval was granted by the NRES - Cornwall and Plymouth Research Ethics Committee (13/SW/013). Dissemination will include publication of quantitative and qualitative findings, and experience of public involvement in peer-reviewed journals.Trial registrationCurrent Controlled Trials: ISRCTN96565376

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“…This makes skin of the elderly prone to tears provoked by traumatisms that younger individuals would tolerate without such sequels. 24 All these objective causes of skin 'fragility' should be confronted with the highly subjective perception of 'fragile' skin. 25 Skin is our interface with the environment and the most visible and expended part of our body, through which we communicate.…”

mentioning

confidence: 99%

Fragility of epidermis and its consequence in dermatology

Stalder

Tennstedt

Deleuran

et al. 2014

Acad Dermatol Venereol

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The skin is the largest organ of the body, providing a protective barrier against bacteria, chemicals and physical insults while maintaining homeostasis in the internal environment. Such a barrier function the skin ensures protection against excessive water loss. The skin's immune defence consists of several facets, including immediate, non-specific mechanisms (innate immunity) and delayed, stimulus-specific responses (adaptive immunity), which contribute to fending off a wide range of potentially invasive microorganisms. This article is an overview of all known data about 'fragile skin'. Fragile skin is defined as skin with lower resistance to aggressions. Fragile skin can be classified into four categories up to its origin: physiological fragile skin (age, location), pathological fragile skin (acute and chronic), circumstantial fragile skin (due to environmental extrinsic factors or intrinsic factors such as stress) and iatrogenic fragile skin. This article includes the epidemiologic data, pathologic description of fragile skin with pathophysiological bases (mechanical and immunological role of skin barrier) and clinical description of fragile skin in atopic dermatitis, in acne, in rosacea, in psoriasis, in contact dermatitis and other dermatologic pathologies. This article includes also clinical cases and differential diagnosis of fragile skin (reactive skin) in face in adult population. In conclusion, fragile skin is very frequent worldwide and its prevalence varies between 25% and 52% in Caucasian, African and Asian population. Conflicts of interests Funding sourcesNone declared. Epidemiology of fragile skinA recent publication by Haftek describes the results of recent survey realized about 'fragile skin'. Fragile skin was perceived to occur in a substantial proportion of individuals from any given country. The survey was done at 5500 people in a representative sample from the population of five countries: France, Sweden, Spain, Japan and the USA. One of the first results was that all of the respondents were able to answer the question. For them, fragile skin has a very specific meaning. The answers varied depending on the population and their phototypes. Between 25% and 30% of 'Caucasian' respondents (white Europeans), 42% of those with typically 'African' skin and 52% of those with Asian skin reported that their skin was fragile. These people are generally young (around 40% of the European sample were aged 15-34 years) and predominantly female. Fragile skin has an important link to skin pathology, as those who claim their skin is fragile are also more likely to have recently suffered a skin condition, to have acne or to have a history of atopic dermatitis (AD).Those at either end of the age spectrum (babies and elderly patients with dermatoporosis) have generally fragile skin. It can also affect people of all ages in certain areas of the body, such as the eyelids, neck, area around the mouth and areas that receive a lot of sun exposure, such as the d ecollet e or forehead. Dermatologists know th...

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A descriptive cross‐sectional international study to explore current practices in the assessment, prevention and treatment of skin tears

Cited by 45 publications

References 9 publications

Skin tears and risk factors assessment: a systematic review on evidence‐based medicine

Skin tears and risk factors assessment: a systematic review on evidence‐based medicine

Pilot randomised controlled trial of protective socks against usual care to reduce skin tears in high risk people “STOPCUTS”: study protocol

Fragility of epidermis and its consequence in dermatology

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