From the Guidelines
For a 90-year-old male with a skin tear, the most effective discharge instructions would involve thoroughly irrigating the wound with a large volume of warm or room temperature potable water with or without soap until there is no foreign matter in the wound, as recommended by the 2010 guidelines for wounds and abrasions 1. When managing a skin tear in a 90-year-old male, it is crucial to prioritize wound care that promotes healing and prevents infection.
- Clean the wound daily with mild soap and water, then gently pat dry.
- Apply a thin layer of antibiotic ointment and cover with a non-stick dressing such as Telfa, securing with paper tape or a wrap bandage to avoid adhesive directly on fragile skin, as suggested by the principles of wound care 1.
- Change the dressing daily or whenever it becomes wet or soiled, and watch for signs of infection including increasing redness, warmth, swelling, pus, foul odor, or fever, which require prompt medical attention.
- Elevate the affected area when possible to reduce swelling, considering the patient's mobility and comfort. The patient should be advised to avoid picking at scabs or removing dressings roughly, as this can reopen the wound and delay healing. Given the fragility of elderly skin due to decreased collagen and elastin, proper wound care is essential to prevent complications, with complete healing typically taking 1-3 weeks depending on the tear's severity 1.
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 The discharge instructions for a 90 year old male with a skin tear may include:
- Cleaning the affected area
- Applying a small amount of bacitracin (TOP) on the area
- Applying the product 1 to 3 times daily
- Covering the area with a sterile bandage 2
From the Research
Discharge Instructions for a 90-Year-Old Male with a Skin Tear
When creating discharge instructions for a 90-year-old male with a skin tear, several factors should be considered to promote healing and prevent further injury.
- The patient's age and potential for skin dryness (xerosis) should be taken into account, as these are risk factors for skin tears 3.
- Discharge instructions should include information on how to keep the skin moisturized, as twice-daily skin moisturisation can help prevent skin tears 4.
- The use of gentle skin cleansers and moisturizing lotions can also help to prevent skin tears 3.
- In terms of wound care, topical antibiotic ointments such as triple-antibiotic ointment (TAO) can be effective in preventing infections in minor skin trauma 5.
- However, other topical wound care ointments such as Aquaphor Healing Ointment (AHO) may also be effective in promoting wound healing and may be considered as an alternative to antibiotic ointments 6.
- It is also important to consider the patient's overall health and any potential allergies or sensitivities when selecting a topical wound care ointment.
- The patient should be instructed on how to properly care for the wound, including how to change dressings and how to monitor for signs of infection.
- The patient's caregiver should also be educated on how to assist with wound care and how to prevent further skin tears.
- Education on the importance of gentle handling and the use of protective devices such as skin sleeves and padded side rails can also help to prevent skin tears 3.