The assessment and management of skin tears in care homes

Stephen-Haynes, Jackie; Callaghan, Rosie; Bethell, Elaine; Greenwood, Michelle

doi:10.12968/bjon.2011.20.sup6.s12

Cited by 19 publications

(22 citation statements)

References 8 publications

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“…Caring for people with fragile skin is a challenge when a minor trauma can result in Skin Tear (ST) (1)(2)(3) . Although some researchers suggest that Skin Tear is more prevalent than pressure ulcers and burns (4)(5) , ST go unnoticed as they are shallow traumatic wounds, occurring mainly in elderly ends resulting from friction or a combination of friction and shear, leading to separation of the epidermis from the dermis (partial thickness wound) or completely separating the epidermis and the dermis from the underlying structures (total thickness wound) (6) .…”

Section: Introductionmentioning

confidence: 99%

“…Although some researchers suggest that Skin Tear is more prevalent than pressure ulcers and burns (4)(5) , ST go unnoticed as they are shallow traumatic wounds, occurring mainly in elderly ends resulting from friction or a combination of friction and shear, leading to separation of the epidermis from the dermis (partial thickness wound) or completely separating the epidermis and the dermis from the underlying structures (total thickness wound) (6) . They are regarded as inherent to the age, inducing the feeling of an irrelevant condition, however, they cause pain and can easily be infected (2)(3)(4)7) . Because they are relegated as mere casual unavoidable incidents, there is little interest and therefore, they are underdiagnosed.…”

Section: Introductionmentioning

confidence: 99%

“…Because they are relegated as mere casual unavoidable incidents, there is little interest and therefore, they are underdiagnosed. The lack of diagnostic accuracy and understanding of the causes involved, contributes to increasing pain and suffering, healing time and treatment costs, negatively affecting the quality of care (2)(3)(4)(7)(8) .…”

Section: Introductionmentioning

confidence: 99%

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Skin tear prevalence and associated factors: a systematic review

Strazzieri-Pulido

Peres

Campanili

et al. 2015

Rev. esc. enferm. USP

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Objective: To identify and analyse skin tear prevalence and factors associated with its occurrence. Method: Systematic review of literature of studies published until June 2014 including studies published in full in English, Spanish or Portuguese. The studies were analysed according to the Strengthening the Reporting of Observational Studies in Epidemiology and the Guidelines for Critically Appraising Studies of Prevalence or Incidence of a Health Problem. Results: The analysis of eight studies showed skin tear prevalence of 3.3% to 22% in the hospital setting and 5.5% to 19.5% in homecare. Advanced age, dependence on basic activities of daily life, frail elderly, level of mobility, agitated behavior, non-responsiveness, greater risk for concurrent development of pressure ulcers, cognitive impairment, spasticity and photoaging were cited as risk factors. Conclusion: Skin tear prevalence ranged from 3.3% to 22% and is mainly associated with advanced age and dependence on basic activities of daily life.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Skin tear prevalence and associated factors: a systematic review

Strazzieri-Pulido

Peres

Campanili

et al. 2015

Rev. esc. enferm. USP

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“…Accurate figures for United Kingdom (UK) prevalence of skin tears are not readily available but a number of UK authors have asserted that many skin tears go unreported (Clothier 2014, All Wales Tissue Viability Forum 2015, Stephen-Haynes and Deeth 2016. It would be reasonable to assume that UK prevalence may be comparable to figures from similarly developed nations with growing elderly populations, such as Australia and the United States.…”

Section: Introductionmentioning

confidence: 99%

Prevention and management of skin tears in older people

McInulty

2017

Emergency Nurse

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“…Typical causes of injury leading to skin tears include wheelchair use, bumping into obstacles, transfers and falls. 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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The assessment and management of skin tears in care homes

Cited by 19 publications

References 8 publications

Skin tear prevalence and associated factors: a systematic review

Skin tear prevalence and associated factors: a systematic review

Prevention and management of skin tears in older people

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

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