Skin tears and risk factors assessment: a systematic review on evidence‐based medicine

Abstract

Skin tears represent a common condition of traumatic wounds, which may be encountered in some categories of individuals at the extremes of age, such as infants and the elderly. Despite the high prevalence and cost of these lesions, there has been little investigation into the risk factors that lead to this condition. The aim of this review was to systematically evaluate the main risk factors involved in development of skin tears. We planned to include all the studies dealing with risk factors related to skin tears. Only publications in English were considered. We excluded all the studies that did not properly fit our research question and those with insufficient data. Of the 166 records found, 24 matched our inclusion criteria. After reading the full-text articles, we decided to exclude seven articles because of the following reasons: (1) not responding properly to our research questions and (2) insufficient data; the final set included 17 articles. From a literature search, we found the following main issues related to risk factors, which have been described in detail in this section: age-related skin changes, dehydration, malnutrition, sensory changes, mobility impairment, pharmacological therapies and mechanical factors related to skin care practices. Our findings clearly show that in frail populations (especially infant and elderly), the stratification risk, as a primary prevention strategy, is an effective tool in avoiding the development of chronic wounds. The development and the implementation of prevention strategies based on appropriate knowledge of the risk factors involved and the adoption of correct techniques during skin care practices could reduce or even avoid the onset of skin tears.

Preventing Facial Pressure Injury for Health Care Providers Adhering to COVID-19 Personal Protective Equipment Requirements

“…Because adhesives increase the risk of skin stripping and subsequent skin tear injuries, 12 the use of an atraumatic silicone dressing on the face also was proposed. The Pressure Injury Prevention Committee repurposed a readily available dressing for facial pressure injury prevention in the absence of existing evidence.…”

Haemorrhage from varicose veins and varicose ulceration: A systematic review

“…Concomitant medical conditions, such as arthritis or weakness from cerebrovascular disease may also predispose to this kind of problem, as these conditions may affect mobility and reactivity of patients . Anticoagulant drugs and skin fragility may also contribute to bleeding and concomitant cardiovascular disease, such as ischemic heart disease, may contribute to the fatal ending of the bleeding episode that happens for subsequent hypovolemic shock. Also, alcohol abuse may enhance the speed of bleeding due to peripheral vasodilation …”

“…Varicose veins are a common sign of CVD with a prevalence up to 56% in men and 73% in woman . Among the complications of VV, especially in elderly that have the skin more fragile than younger, severe bleeding may be encountered in clinical practice and this can be fatal, especially in presence of comorbidities such as ischemic heart disease . In physiological conditions and in case of traumatic haemorrage, as the venous system is under low pressure, the coagulation via the coagulation cascade occur spontaneously and rapidly than the arterial system .…”

Foot Care Knowledge and Practices among Japanese Nurses and Care Workers in In-home Service Providers: A Cross-Sectional Study

“…Considering the decreased elasticity, dryness, and fragility of older people' skin, identifying factors that trigger skin tears on their arms and feet can prevent further skin problems. Accordingly, Serra R et al had reported risk factors for skin tears among frail populations [33]. Notably, small stones or objects inside the shoes may lead to skin breakage on the foot.…”