Treatment of Skin Tears
For skin tears, immediately cleanse the wound with warmed sterile water or saline, reposition any skin flap to cover the wound bed, apply a greasy emollient (50% white soft paraffin with 50% liquid paraffin), and cover with a non-adherent dressing followed by a secondary foam dressing. 1
Initial Wound Management
Cleansing and Debridement
- Gently irrigate the wound using warmed sterile water, saline, or chlorhexidine (1:5000 dilution) to remove debris and reduce bacterial load 1
- Avoid aggressive cleansing that could further damage fragile tissue 1
- Remove only superficial debris; deeper debridement is usually unnecessary and may impair healing 2
Skin Flap Management
- Reposition any detached skin flap to cover the wound bed, as it acts as a biological dressing 1
- If blisters are present, decompress them by piercing and expressing or aspirating fluid while maintaining the blister roof as protective coverage 1
- The detached epidermis may be left in situ to serve as a natural barrier 2
Dressing Protocol
Primary Dressing Application
- Apply a greasy emollient (such as 50% white soft paraffin with 50% liquid paraffin) over the entire wound area to maintain moisture and prevent dressing adherence 1
- Cover with a non-adherent primary dressing such as Mepitel™ or Telfa™ to prevent disruption of healing tissue 1
Secondary Dressing
- Apply a secondary foam or burn dressing (such as Exu-Dry™) to collect exudate and provide protection 1
- Change dressings every 5-7 days if no complications arise, or more frequently based on exudate levels 1
Infection Management
Monitoring and Prevention
- Monitor for signs of infection including increased pain, erythema, increased exudate, or odor 1
- Take wound swabs for bacterial and candidal culture from lesional skin if signs of infection develop 1
- Administer systemic antibiotics only if clinical signs of infection are present—do not use prophylactically 1
Topical Antimicrobials
- Apply topical antimicrobial agents only to sloughy or infected areas, not routinely 1
- Consider silver-containing products or dressings for infected areas, guided by local microbiological advice 1
What to Avoid
Common pitfalls in skin tear management include using inappropriate dressings and unnecessary antimicrobials:
- Do not use honey or bee-related products for wound healing 1
- Avoid collagen or alginate dressings for routine treatment 1
- Do not routinely apply topical antiseptic or antimicrobial dressings in the absence of infection 1
- Avoid adhesive dressings that may cause further skin tears upon removal 3