Skin tears

[84RN]

What's the best way you've found to dress/treat skin tears in elderly patients? I have a patient right now (home health) that has several, and having trouble keeping the wound from sticking to the dressing, even with using Xerofoam and telfa.

[EverNurseRN]

I use non-adherent telfa and bacitracin if they are not allergic. If it's a clean, new tear and you can clean it with normal saline and get the skin back together (re-approximate) then apply steri strips this will heal it faster (just don't cover it with anything as the point is for it to dry and heal). Geri sleeves are good to wear if their skin is prone to tears..also lotion intact skin a few times a day to promote integrity along with encouraging fluids and good nutrition will cut down on tears!

[thesundowner]

adaptic held in place with 4x4s and kling - adaptic won't stick to anything! change q3day and prn

[turnforthenurse, MSN, NP]

We use Tegaderm

[Nursetastic]

We use Mepilex dressings. Either the border dressings or the transfer dressings. They seem to really help. I agree with moisturizing the skin, too.

[Salisburysteak, BSN, RN]

I have used steri-strips, and I have used Tegaderm or Op-site(same thing). And geri-sleeves work very well. If the client is elderly she/he will appreciate the extra warmth on their body.

[AMN74]

Yeah, I use a lot of tegaderm on skin tears, cover them for 7 days, the the fluid collect (tell the patient a puddle of fluid under the clear bandage may be normal, have them call if it is leaking/draining, or can roll kerlex over it. the getting it off part is that you stretch the tegaderm almost in a lateral position away from the skin and it just loosens right up. Clean up the drainage, reappy if you don't see granulating or epithelial skin. Mepatel works well too with a dsd over it and wrapped with some kerlex.

[amoLucia]

Does your agancy have any P&P you need to go thru first? If they leave it to your good judgement and cost & availability are not issues, opsite is freq used in LTC. Proactive prevention with good skin care, nutrition/hydration, vit C, helps, esp with some kind of geri-sleeves (purchased or homemade) helps.

[NicuGal, MSN, RN]

We use Mepitel on our little ones...their skin tears like the elderly's do. It is great because you can apply an ointment also!

[Do-over, ASN, RN]

I like adaptic.

[JZ_RN]

Our facility doesn't pay for any fancy dressings. It's kling or a 4x4 and paper tape over some TAO or alginate if it can't be closed with steri-strips.