Healing in Motion: A Case Study to treat Skin Tears in an Older Adult

A skin tear is described as a “ traumatic wound caused by mechanical forces, including removal of adhesives. Severity may vary by depth (LeBlanc et al, 2018)." Skin tears are a frequent challenge in the geriatric population due to the changes in skin over lifespan. 
An eighty-two year old male with a history of hypertension, GERD and hyperlipidemia reported frequent skin tears to his lower extremities. A full time resident in Florida, the patient walks daily with his wife of sixty-two years to the beach as a part of his normal activities of daily living (ADL).  The patient reported frequent skin tears as a result of carrying his beach chairs. Patient presented with a 2cm x 1.2cm partial thickness tear to his right anterior lower extremity. Patient reported challenges with managing his care at home due to cost of dressings, aggressive adhesive, and inability to maintain wear time longer than 24 hours. 
Upon assessment, wound was fully obstructed with necrotic tissue. To support autolytic debridement, a multi-layer silicone border foam was applied and left in place for three (3) days. After three days, the wound was cleansed by the patient with water and hydrogen peroxide to remove debris from wound bed.  A second dressing was applied and left in place for six days. Patient reported full closure of wound upon removal of the dressing by the tenth day of treatment. 
Healing and support of the patient's daily activity was achieved through application of the flexible bordered foam dressing. An observation to this case study was the feedback from the patient who did not have to conduct daily dressing changes, have further skin damage or pain with his regime. While wearing the multi-layer silicone bordered foam dressing, the patient described a greater ability to perform his normal ADL and to carry his and his wife’s beach chairs, without trauma to the skin.

Case Study, Treatment

Trademarked Items (if applicable): Mepilex Border Flex

References (if applicable): LeBlanc K, Baranoski S. Skin tears: the underappreciated enemy of aging skin. Wounds International. 2018;9(1):6-10.