What is the best wound care approach for a skin tear?

Optimal Wound Care for Skin Tears

For skin tears, gently cleanse with warmed sterile water or saline, reposition any skin flap over the wound bed, apply a greasy emollient (50% white soft paraffin with 50% liquid paraffin), cover with a non-adherent dressing, and use a secondary foam dressing to manage exudate. 1

Initial Wound Cleansing

• Irrigate the wound gently 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 or extend the injury. 2, 1
• Remove only superficial debris—deeper debridement is usually unnecessary and may impair skin closure and healing. 2

Skin Flap Management

• Reposition the detached skin flap to cover the wound bed, where it acts as a natural biological dressing. 2, 1
• If blisters are present, decompress them by piercing and expressing or aspirating the fluid, but leave the blister roof intact as a protective covering. 2, 1
• The detached epidermis should be left in place to serve as a natural barrier rather than removed. 2, 1

Dressing Application

• Apply a greasy emollient (such as 50% white soft paraffin mixed with 50% liquid paraffin) over the entire wound area, including denuded areas, to maintain moisture and prevent dressing adherence. 2, 1
• Cover with a non-adherent primary dressing such as Mepitel™ or Telfa™ to prevent disruption of healing tissue. 2, 1
• Apply a secondary foam or burn dressing (such as Exu-Dry™) to collect exudate and provide additional protection. 2, 1
• Change dressings based on exudate levels, typically every 5-7 days if no complications develop. 1

What NOT to Use

• Do not use topical antiseptic or antimicrobial dressings routinely for wound healing, as they do not improve outcomes. 2, 1
• Do not use honey or bee-related products for wound healing. 2, 1
• Avoid collagen or alginate dressings for routine treatment. 2, 1
• Do not apply topical antibiotics unless there are clear clinical signs of infection. 2, 1

Infection Monitoring and Management

• Monitor for signs of infection including increased pain, erythema, purulent exudate, or odor. 1
• Take wound swabs for bacterial and candidal culture from affected areas if infection is suspected. 2, 1
• Administer systemic antibiotics only if there are clinical signs of infection—not prophylactically. 2, 1

Expected Healing Timeline

• Skin tears typically heal within 7-21 days when managed properly with this approach. 1, 3
• If healing is disrupted, these acute wounds can become chronic and non-healing, compromising quality of life. 3