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for the prevention & treatment of skin tears

Catherine A. Sharp & Eileen Wilkins The Wound Centre® Sydney, Australia

This is the skin of a 12 year old girl – healthy, nourished and smooth...

...and this is the skin of an 82 year old woman fragile, dry, rough and ecchymotic. 1

See how it changes in 70 years!
Can you imagine how frail the skin of this elderly woman is; how thin and rough it feels and how easily it can tear?


Bruising caused by ruptured blood vessels into subcutaneous tissue, the purplish discoloration of the skin


Sharp Clinical Solutions © answers all your questions about preventing and treating skin tears. This is a book for owners and managers of facilities; for families and carers; for assistants in nursing, doctors and nurses, physiotherapists, podiatrists; in fact anyone who cares for the aged.

There are five sections in this book, all of which fit together like a jigsaw to give great information on how to prevent and treat skin tears. I have written this book so it is simple to read, because I know you have far too much to do; and wound care is too confusing, even for the most experienced registered nurses and doctors. You can prevent skin tears by providing outstanding, gentle, quality care for your patients; and you will save time as well as money.

I do not expect you to learn skin tear classification systems because the treatment is the same for all skin tears, unless the tear is full thickness and / or has an underlying fracture, requires hospitalisation, suturing and / or immobilisation of the limb. I do not expect you to draw arrows on dressings either. Read my blogs to find out why... I want you to have less work yet be more efficient. DISCLAIMER The information in this book is provided in good faith. It is not intended to be a substitute for professional care. Healthcare professionals should ensure they have the skills and qualifications in wound management before utilising any of the information in this book. A multi-disciplinary approach to treatment and an understanding of the wound aetiology, infection control issues and the objectives for management, will give the best results. To Patients Buying this Book If you are a patient with a wound you should bear in mind that your situation may be quite different from any examples given in this book. It is very important that you consult with a health care professional with expertise and training in this area of health care.



Silicone dressings HiCare Bath Cloths Activities of daily living Risk Screening Protection for limbs






An easy way to remember all that you need to do is to just THINK SHARP © because I know you really can! You can start in any section of the book. If you have a patient 2 who already has a skin tear you may wish to start at ‘S’= silicone dressings. If you want to determine if your patients are at risk of skin tears start at ‘R’= risk screening.


The term patient includes residents, person and clients.


What is a skin tear? What does it look like?
Skin tears occur commonly in the aged. The epidermis (top layer of the skin) is torn away from the dermis (deeper layer of the skin), although occasionally both epidermis and dermis are torn away leaving a full thickness flap. A skin tear may look like this... ... a large area of skin has been completely torn off.

Figure 1 forearm tear ...or this...

Figure 2 upper arm tear ...the edges of the flap have been brought together as much as they can be. Whether the flap survives is not known at this stage... ...or this...

Figure 3 lower leg (shin) tear … the edges of this skin flap have come together perfectly. This is known as primary intention healing. The flap looks dark and may not survive however. The treatment for all these...
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