Treatment for Skin Tears
Skin tears should be managed with gentle cleansing using warmed sterile water or saline, followed by re-approximation of the skin flap (if viable), application of a greasy emollient, and coverage with non-adherent dressings to maintain a moist wound environment. 1
Immediate Wound Management
Cleansing Protocol
- Gently cleanse the wound using warmed sterile water, saline, or a mild antimicrobial such as chlorhexidine 1
- Avoid harsh scrubbing or antiseptics that may damage fragile tissue 1
- Remove any debris carefully without disrupting the skin flap 2
Tissue Handling
- Carefully reposition any viable skin flap back over the wound bed 3
- Treat the flap as a skin graft rather than relying on its compromised blood supply 3
- Use wound closure strips to re-approximate the tissue edges 3
Dressing Selection
- Apply a greasy emollient (such as plain petrolatum ointment) directly to the wound 4, 1
- Cover with non-adherent dressings to prevent tissue disruption during dressing changes 4, 1
- Maintain moisture balance to optimize healing 1
Advanced Treatment Considerations
Negative Pressure Wound Therapy
- For larger skin tears (>8 cm), consider disposable negative pressure wound therapy as a bolster to improve flap viability 3
- This approach can achieve 100% tissue viability by day 5 in appropriate cases 3
Expected Healing Timeline
- Most skin tears heal within 7-21 days when properly managed 2
- Therapeutic benefit should be observed within 3-5 days, with clinically relevant improvement by 1 week 4
Infection Management
Monitoring for Complications
- Assess for signs of cellulitis: spreading erythema, warmth, increased pain, or systemic symptoms 1
- Check for purulent drainage or delayed healing beyond expected timeframe 2
Antibiotic Considerations
- Consider MRSA coverage if cellulitis develops or systemic signs appear, particularly in areas where MRSA prevalence exceeds 20% 1
- Avoid routine topical antiseptics or antimicrobial dressings once infection is controlled, as these may impair healing 1
Critical Pitfalls to Avoid
- Never use alcohol-containing products or harsh antiseptics that enhance dryness and tissue damage 4
- Avoid adherent dressings that will traumatize the fragile tissue upon removal 4
- Do not ignore the skin flap viability—reposition it even if blood supply appears compromised 3
- Avoid delayed treatment, as early intervention within the first few days significantly improves outcomes 4