From the Guidelines
To treat a skin tear, cleaning the wound gently with warm saline or water is crucial, followed by covering it with a clean occlusive dressing and/or a topical antibiotic that keeps the wound moist and prevents drying, as recommended by the 2010 American Heart Association and American Red Cross international consensus on first aid science 1. When treating skin tears, it's essential to prioritize wound care and prevention of infection.
- Cleaning the wound gently with warm saline or water is the first step in treating a skin tear.
- If the skin flap is still viable, reposition it over the wound to promote healing.
- Applying a non-adherent dressing, such as a silicone-based dressing, hydrogel, or petroleum gauze, directly over the tear can help keep the wound moist and promote healing.
- Securing the dressing with a secondary dressing like gauze and paper tape, avoiding adhesives directly on fragile skin, is also important.
- Changing dressings every 3-5 days, unless drainage or signs of infection appear, can help prevent infection and promote healing.
- For pain management, acetaminophen (500-1000mg every 6 hours as needed) is typically sufficient, but it's essential to monitor for signs of infection, including increased redness, warmth, swelling, or purulent drainage.
- Most skin tears heal within 7-14 days with proper care, and prevention is crucial for those with fragile skin, including daily use of moisturizers, safe movement techniques, padding furniture edges, and avoiding adhesive products on vulnerable skin, as skin tears occur when the epidermis separates from the dermis due to friction or shearing forces, most commonly in elderly individuals or those with fragile skin conditions.
From the FDA Drug Label
Directions adults and children 2 years of age and older: clean the affected area apply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times daily may be covered with a sterile bandage Uses first aid to help prevent infection and for the temporary relief of pain or discomfort in minor: cuts scrapes burns
Skin Tear Treatment:
- Clean the affected area
- Apply a small amount of bacitracin (TOP) on the area 1 to 3 times daily
- May be covered with a sterile bandage 2 2
From the Research
Skin Tear Treatment Overview
- Skin tears are acute wounds caused by mechanical forces, such as blunt trauma, and are commonly found at the extremes of age 3.
- These wounds can be preventable with the implementation of a risk-reduction programme, which includes twice-daily skin moisturisation 3.
- The International Skin Tear Advisory Panel (ISTAP) best practice recommendations suggest holistic strategies to promote and maintain skin integrity 4.
Treatment Options
- A low-cost, cyanoacrylate-based liquid dressing can be an effective treatment for minor nonbleeding abrasions and class I and II skin tears, eliminating the need for topical antibiotics and dressings 5.
- This liquid dressing can be applied only once and has been shown to have a median time to complete healing and sloughing of the overlying scab of 10 days 5.
- Traditional treatments, such as gauze dressings and topical antibiotics, may require frequent and messy dressing changes 5.
Prevention and Management
- Identifying those at risk can help with the development of a specific preventive approach, and education and implementation of prevention protocols can reduce the incidence of skin tears in extended care facilities by almost 50% 6.
- A combination of skin protection, preventive measures, and treatments that facilitate moist wound healing appear to be most effective in managing skin tears 6.
- Risk factor and epidemiological studies, as well as research to validate the existing skin tear classification system, are needed to improve clinician ability to provide evidence-based risk assessments, preventive care, and treatment 6.
Considerations
- Topical antibiotics, such as bacitracin, are commonly used for acute skin injuries and chronic wounds, but the incidence of allergy to these agents has been increasing over the last 10 years 7.
- Clinicians should be aware of the potential for allergic reactions to topical antibiotics and consider alternative treatments when necessary 7.