Can a skin tear evolve into a pressure ulcer?

[RiverNurse]

Hi all,

I had a patient that I took care of that, per report, had a skin tear to the right of his coccyx. When I assessed the wound, it was oval in shape and was 2 cm X 1.5 cm. The area around the wound was red, the wound bed was pink - no slough.

To me, it appeared to be a classic stage II ulcer, but I was told that I was incorrect, it was a skin tear. So, my question is, can a skin tear evolve into a pressure ulcer, given the location of the initial wound?

Also, I'm wanting to specialize in wound care. I'll be perusing this thread and eventually bombard the boards with questions .

Take care,

RiverNurse

[mommy.19, MSN, RN, APRN]

RiverNurse,

Given that the etiology of a decubitus ulcer, one could form almost anywhere. However, without seeing this wound I am guessing that someone has stated the etiology of this wound incorrectly either by accident (did not know what they were looking at) or purposefully did so to avoid repercussions. A skin tear -generally- presents more as a jagged looking rip, not what you're describing. It would be difficult, in my opinion, again, without having seen the actual patient, for someone to have a skin tear in that location. Does the periwound blanch at all? does the patient have any other decubitii that appear similar to this or any other skin tears that resemble it? Sorry, I seem to only have more questions for you :)

[CarreBarreLPN, ASN, RN]

To answer the question, technically no. The etiology of a wound will not change however, it can be complicated by any number of things including pressure.

[alphabetsoup]

If you experience a breach in skin integrity, such as a gluteal tear (commonly caused when caregivers pull patients by their gluteals for turning/repositioning) and then compound the problem with pressure/friction/shearing, then yes- a pressure ulcer can develop, even if the initial injury was a skin tear.