What is the recommended treatment for skin tears?

Treatment of Skin Tears

For skin tears, immediately reposition the skin flap as a biological dressing, cleanse gently with warmed sterile water or saline, apply a greasy emollient, and cover with a non-adherent primary dressing followed by a secondary foam dressing to collect exudate. 1

Immediate Wound Management

Initial Cleansing

• Gently irrigate the wound using warmed sterile water, saline, or a mild antimicrobial solution (such as chlorhexidine 1:5000) to remove debris and reduce bacterial load 2, 1
• Avoid aggressive cleansing techniques that could further damage the fragile tissue 1

Skin Flap Management

• Reposition any skin flap to cover the wound bed, allowing it to act as a biological dressing 2, 1
• This is a critical step that distinguishes skin tear management from other wound types—the flap itself provides optimal coverage 1
• If blisters are present, decompress them by piercing and expressing or aspirating the fluid while maintaining the blister roof as a protective covering 2, 1

Dressing Protocol

Primary Layer

• Apply a greasy emollient (such as 50% white soft paraffin with 50% liquid paraffin) over the entire wound area and intact epidermis to maintain moisture and prevent dressing adherence 2, 1
• Cover with a non-adherent dressing such as Mepitel™ or Telfa™ to prevent disruption of healing tissue during dressing changes 2, 1

Secondary Layer

• Apply a secondary foam or burn dressing (such as Exu-Dry™) to collect exudate and provide cushioning protection 2, 1
• Change dressings based on exudate levels, typically every 5-7 days if no complications develop 1

Infection Monitoring and Management

Surveillance

• Monitor closely for signs of infection including increased pain, erythema, purulent exudate, or odor 1
• Take wound swabs for bacterial and candidal culture only if clinical signs of infection develop 1

Antimicrobial Use

• Administer systemic antibiotics only when clinical signs of infection are present—prophylactic antibiotics are not indicated 1
• Apply topical antimicrobial agents only to sloughy areas, with the choice guided by local microbiological advice 2
• Consider silver-containing products/dressings for infected areas, though use should be limited if extensive areas are being treated due to absorption risk 2

What NOT to Do

Critical pitfalls to avoid:

• Do not use topical antiseptic or antimicrobial dressings for routine wound healing in uncomplicated skin tears 1
• Avoid honey or bee-related products for wound healing 1
• Do not use collagen or alginate dressings for routine treatment 1
• Avoid adhesive dressings that could cause additional skin tears upon removal 3

Expected Healing Timeline

• Skin tears typically heal within 7-21 days when managed properly 1, 4
• If healing is delayed beyond this timeframe or complications arise, consider referral to wound care specialists 5

This evidence-based approach prioritizes maintaining the skin flap as a biological dressing and using moisture-retentive, non-adherent dressings—a strategy that differs from treating skin tears as open wounds requiring debridement. 1