skin tears

[bebop1]

ok. I am a home health nurse I have been getting a lot of patients out of a rehab center that has skin tears but all they do with them is put a tegaderm on them.

so when they finally get home, they have an old tegaderm, with an old infected skin tear underneath. that usually still has all the old blood under there too. that when I get the tegaderm off, just pulls off more skin, and bleeds more. Just the other day the tegaderm had a date of 9 days ago. the patient said the nurses were waiting for it to just fall off. when you could see that the area was infected.

what do you recommend for skin tears? we usually use adaptic? and then cover it? if that is what ya all do? how long? or what do you recommend? and how often to change it?

Thanks!!!:monkeydance:

[missyp]

We use vaseline gauze, and wrap it in either gauze or Kerlix wrap. Depending on the amount of drainage change the dressing BID, if the wound tends to drain it is best to change more frequently or else the vaseline gauze will stick to the skin. Hope this can help you.

[nservice]

I've used polymem and secured with kerlex. polymem helps cleanse the wound and is absorbent. It's kind of expensive though.

[sharlynn]

If the flap can be approximated, cleanse with NS, approximate and apply paper tape strips or steri strips ( My facility had a VERY cost conscious meical director). Unless there are signs of infection, leave it alone until the tape falls off.

If there is no flap or it cannot be approximated, cleanse with NS, apply triple antibiotic ointment, adaptic and gauze wrap. Change bath days and PRN.