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Skin Tear Healing Using Polymeric Membrane Dressings*
Clinical Problem: A 70-year-old man with Parkinson’s disease, restless leg syndrome, and Neuropathy fell several times, causing three different superficial skin tears. One on left forearm was approximately 7.6 cm x 7.6 cm, one on the right shin was approximately 5 cm x 5 cm, and one on the left buttock was approximately 8 cm x 2 cm. The forearm bled severely and was extremely painful with moderate to large tissue loss. The shin had limited tissue loss. The buttock skin tear was more superficial with extensive bruising of the periwound. Swelling, inflammation, and pain were associated with all injuries. The goal was to maximize healing while minimizing complications and pain associated with each skin tear.
Past Management: No past management.
Clinical Treatment: Approach Each wound was cleansed gently with normal saline to remove clots and debris. The bleeding stopped with gentle pressure. All three skin tears were covered with a polymeric membrane dressing* (PMD)* with an adhesive border or secured with a wrap covering. The dressings were changed daily after showering.
Outcomes: The PMDs resulted in pain reduction for all skin tears. Buttock pain reduced from severe to tolerable within one hour of applying PMDs. In addition, the PMD reduced any bruising, inflammation, and no infection occurred. Complete healing occurred in seven days with each skin tear.
Conclusions: Skin tears become more common with aging because the skin becomes drier and more delicate. Unlike healthier skin that stretches when stressed, delicate skin can tear with relatively little pressure. PMDs, applied to skin tears, alleviated pain, bruising, and decreased inflammation. PMDs also helped to reduce treatment costs because neither topical antibiotic or pain medications were needed. Therefore, PMDs made significant positive outcomes for this patient with numerous comorbidities.
References
Sierra, R., Lelapi, N., Barbetta, A., & de Francisis, S. (2018). Skin tears and risk factors assessment: a systematic review on evidence‐based medicine. International Wound Journal, 15(1), 38-41. https://doi.org/10.1111/iwj.12815
Campbell, K., LeBlanc, K., & Woo, K. (2018). Best practice recommendations for the prevention and management of skin tears in aged skin: an overview. Wounds International, 9(3),66-70.
Lewin, G.F., Newall, N., Alan, J.J., Carville, K.J., Santamaria, N.M., & Roberts, P.A. (2016). Identification of risk factors associated with the development of skin tears in hospitalized older persons: a case–control study. Int Wound J, Dec. 13,1246–1251. https://doi.org/10.1111/iwj.12490
Trademark
* PolyMem® Wound Dressing, Ferris Mfg. Corp., Fort Worth, Texas