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Skin Tear and Duoderm Question

Wound   (13,042 Views 12 Comments)
by bshaw96 bshaw96 (New Member) New Member

2,521 Visitors; 80 Posts

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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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sharlynn has 43 years experience and works as a Wound Nurse, LTC, Hospice.

4,776 Visitors; 318 Posts

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.

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txspadequeenRN has 20 years experience and works as a RN.

28,789 Visitors; 4,373 Posts

approximate the edges and put on some steri strips...simple and easy....

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sharlynn has 43 years experience and works as a Wound Nurse, LTC, Hospice.

4,776 Visitors; 318 Posts

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!

:nono:

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jnette has 10 years experience and works as a Home Health Patient Education Resource Nurse.

1 Like; 25,723 Visitors; 4,388 Posts

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.

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557 Visitors; 1 Post

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

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rainbowsandsunshine works as a LTC.

2,007 Visitors; 44 Posts

Working in LTC, we also use steri-strips (if small and skin flap intact), or tegaderm (large or missing/altered skin flap)

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mommy.19 has 7 years experience and works as a APRN.

7,947 Visitors; 262 Posts

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.:uhoh3:

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annaedRN has 10 years experience and works as a home health nurse.

6,637 Visitors; 519 Posts

love xeroform and tegaderm. not even considered duoderm

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tangobango has 16 years experience and works as a Home Health.

2,364 Visitors; 23 Posts

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.

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857 Visitors; 7 Posts

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!!

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