Xeroform Application for Skin Tears
Apply Xeroform (petrolatum-impregnated gauze with 3% bismuth tribromophenate) directly to the skin tear as a nonadherent primary dressing, cover with an absorbent secondary dressing, and leave undisturbed for 5-7 days to allow re-epithelialization. 1, 2
Application Technique
Primary Dressing Layer:
- Cleanse the wound gently with warmed sterile water, saline, or dilute chlorhexidine (1:5000) to remove debris without causing further tissue damage 1
- Apply Xeroform directly to the denuded skin surface, ensuring complete coverage of the wound bed 1, 2
- The Xeroform acts as a scaffold for re-epithelialization and will naturally separate from the wound as healing progresses 3, 4
Secondary Dressing Layer:
- Cover the Xeroform with dry coarse-mesh gauze or foam dressing to absorb exudate 2
- Secure with appropriate wrap (such as Kerlix or similar) without excessive compression 5, 2
Dressing Change Protocol
Initial Management:
- Leave the entire dressing intact for 5 days unless signs of complications develop 2, 4
- The Xeroform will adhere to the wound while allowing exudate drainage through its mesh structure 3, 4
- Change only the outer absorbent layer if it becomes saturated, while leaving the Xeroform layer undisturbed 5, 2
Subsequent Care:
- After 5 days, inspect the wound edges for healing progress 2
- Allow the Xeroform to spontaneously separate as re-epithelialization occurs beneath it—do not forcibly remove 3, 4
- This typically occurs between 10-13 days for partial-thickness wounds 6, 3, 4
Monitoring for Complications
Inspect daily for:
- Excessive drainage soaking through to outer dressings 5
- Purulent discharge or foul odor suggesting infection 5
- Increased erythema extending beyond wound margins 5
- Patient reports of escalating pain (may indicate infection or inadequate coverage) 5
Important caveat: While Xeroform has demonstrated low infection rates in burn studies 1, 6, maintain sterile technique during application and monitor closely for any signs of wound infection 5
Critical Pitfalls to Avoid
- Do not apply excessive moisture that could macerate surrounding intact skin and compromise healing 5
- Avoid premature removal of the Xeroform layer, as this traumatizes the healing wound bed and disrupts re-epithelialization 3, 4
- Do not wrap too tightly, as this compromises circulation to the healing tissue 5
- Avoid topical antimicrobials over the Xeroform unless specifically indicated for infection, as they are not routinely recommended for wound healing 1
Evidence Supporting This Approach
The use of Xeroform for skin tears follows principles established in burn and wound care literature. Studies demonstrate 98.5% graft take rates when Xeroform dressings remain undisturbed for 5 days 2, with healing times of 10.5 days for donor sites 6 and 12-13 days for partial-thickness burns 3, 4. The dressing significantly reduces the number of painful dressing changes compared to traditional methods (median 0.5 vs 12 changes) while maintaining equivalent healing outcomes 4.