Skin Tear and Duoderm Question

  1. I have a HH patient with a skin tear on the back of her LLL. The skin pretty much peeled off so there were no edges to approximate. I am by no means a wound care expert, so I just did what I'd seen done in the past. I cleansed it with NS, applied a vaseline gauze type product, and wrapped it with Kerlex and paper tape. The family is going to change it once daily. Well, she's a once a week patient and I didn't see her last week, another nurse did. Well, when this nurse saw her she got the tx changed to duoderm. I've never seen that on a skin tear before and it seems to me to have made it worse, especially when it pulls off, even after 3-5 days. She has very fragile skin and the idea of putting duoderm on it scares me to death. But again, I'm not by any means well versed in wound care, and the doc just goes along with whatever we recommend. What have been your experiences? I know when I worked in LTC we just put tegaderms over them or tegaderm plus if it was draining. We used hydrogel or vaseline gauze on the worse ones. But I've never seen duoderm for a skin tear. But being the newbie here, don't wanna step on any toes, especially not being that versed in wound care. Will the duoderm do the trick? Thanks for any input!
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    About bshaw96

    Joined: Dec '06; Posts: 81; Likes: 19


  3. by   sharlynn
    I agree with you. I have never used Duoderm on a skin tear, just the treatments you described. The skin is too fragile where skin tears are common.
  4. by   txspadequeenRN
    approximate the edges and put on some steri strips...simple and easy....
  5. by   sharlynn
    Quote from txspadequeen921
    approximate the edges and put on some steri strips...simple and easy....
    you can't approximate if there is no flap without making a very mishaped scar. i've seen some- and believe me, it isn't pretty!
  6. by   jnette
    Wow... have never put Duoderm on a skin tear either for the same reasons given above. We always do just as the OP descrbed.. works beautifully.

    I agree.. duoderm would only cause more damage peeling it off.
  7. by   Nurse Lena
    I was very surprised when my colegue put a duoderm on skin tear of this elderly patient!!I had a hardest time taking it off and think more damage was done that good.I used Mepilex dressing which is extremly helpful in healing and does no damage to the skin whatsoever
  8. by   rainbowsandsunshine
    Working in LTC, we also use steri-strips (if small and skin flap intact), or tegaderm (large or missing/altered skin flap)
  9. by   mommy.19
    I agree with the consensus here, adaptic or mepitel one over the wound and maybe a gauze wrap like conform or kerlix---duoderm is waaaaayyyy too adherent for fragile steroid-like skin.
  10. by   annaedRN
    love xeroform and tegaderm. not even considered duoderm
  11. by   nola1202
    I love Mepilex!
  12. by   tangobango
    Quote from nola1202
    I love Mepilex!
    Me Too!!! Add a bit of skin prep and leave it alone for up to a week. Can put a tegaderm over it for the ability to shower.
  13. by   TVN2011
    I would agree with previous posts.
    Mepilex/ mepilex bordered is ideal for these skin tears when the edges cannot be approximated.
    Duoderm would further damage this fragile skin!!