Derm Detective: Clues: Bruised, Torn Skin

Identification of risk factors associated with the development of skin tears in hospitalised older persons: a case–control study

“…As a result of the slow replenishment of epidermal cells, which is an inevitable physiological change associated with skin as one ages, it will take longer to repair a skin tear (1). Both of these effects may explain why a previously healed skin tear plays an important role in our model and why they have been previously identified as potential risk factors by a number of authors (4,5,10,13,23,26,27).Given the strength of the association found in this study and the localised nature of any vulnerability related to the site of a previous skin tear, an alternative explanation may be that evidence of previous skin tears simply indicates that a person's skin is particularly susceptible to tearing and/or that because of their own or others' behaviour their skin is subject to more frequent trauma.…”

“…This study has proposed a simple model to explain skin tear development using six variables: four that describe characteristics of the individual's skin; the fifth, oedema, that directly affects the skin; and the sixth, the inability to independently reposition, which reflects the physical status of the person and the need for frequent handling. In a number of earlier publications , five of the six have been identified previously to be associated with skin tears, or as potential risk factors for their development.…”

Use of adhesive surgical tape with the absorbable continuous subcuticular suture

“…Open lesions may be accompanied by erythema and blister formation on the perim­eters. Older adults are at increased risk because of dermal thinning and weakening of the dermal−epidermal junction 40 …”

Treating skin tears in nursing home residents: A pilot study comparing four types of dressings

“…Skin tears are defined as acute partial thickness wounds which involve a separation of the dermis from the epidermis 1 , 2 . When a skin tear occurs, a flap is created; the tear itself is usually jagged or angular and the wound usually does not require suturing.…”

“…Considering the clinical importance of skin tears, there appears to have been relatively little systematic research on skin tears. Research does show, however, that skin tears most commonly occur on the extremities; in particular, the hands and forearms 1 , 3 . One epidemiological study of skin tears in aged residents of a large institution revealed that over a 12‐month period skin tears occurred at the rate of approximately one tear per resident per year 3 .…”