When not given the proper care, horses are prone to skin conditions such as dandruff, folliculitis and allergies among others. Humans too are as vulnerable to skin conditions. Perhaps, many of us have experienced having unusual skin conditions at one point in our life. It could be a skin allergy, lesions, some pimples or acne on the face or tattoo scabbing if you had a tattoo. Different types of skin problems require different kinds of treatment. However, one of the most challenging skin problems to prevent and treat is a skin tear. Yet, many people most especially older adults are prone to this problem.
Skin tears refer to traumatic wounds resulting from the separation of the two major layers of the skin, which are the epidermis and dermis. Aging is one of the primary factors that make a person susceptible to this condition.
Managing skin tears involves performing a series of steps that must be done with utmost care and using the right instruments. The main goal on managing tears is to protect the surrounding tissue, preserving the skin flaps, and reducing further injury and infection. The general guidelines include:
1. Stop the bleeding (hemostasis).
Once a person gets a tear in the skin, the first step is to control the bleeding.
- Apply pressure on the affected area. Elevate the limb, if applicable or possible.
- Once the bleeding has stopped, clean the wound using water or saline to remove any debris and residual hematoma.
- Carefully and gently dry the surrounding skin using a clean soft towel.
2. Manage the skin flap.
- Check if the skin flap is still viable. If it is, carefully flap it back into place using a pair of tweezers, dampened cotton or gloved finger.
- If the flap is already difficult to align, you could rehydrate it using a moist non-woven swab every five to 10 minutes.
- If needed, you could apply a skin barrier product to protect the skin around the wound.
3. Apply the dressing.
A wide range of dressing can be used for skin tears. This includes calcium alginates which can help in the bleeding. Silicone dressing can be useful to secure the flaps. There is also fiber or foam dressing which is applicable for exudate management. Exudate refers to fluids that seep out of the blood vessels. To control infection, there are also antimicrobial dressings available. However, avoid using adhesive dressings as they can be difficult to remove and may cause further injury to the skin.
Once an appropriate dressing has been selected, apply it on the affected area and then you could use tissue glues for securing the flap. Because of the fragility of the skin, staples and sutures are not recommended. Leave the dressing for several days to allow the flap to recover. In case an opaque dressing has been used, it is recommended to make an arrow marking to indicate the preferred direction in which the dressing must be removed.
4. Change the Dressing.
When it is time to change the dressing, be gentle in lifting and removing it. Removal should be done away from the still-attached skin flap. If an arrow is indicated, follow the direction of the arrow when removing the dressing. There are also silicone-based adhesive removers as well as saline soaks that can aid in easy removal.
After removing the dressing, clean the wound but be careful not to damage the skin flap.
5. Monitor the progress of the wound.
Observe the progress of the wound especially in the first 48 hours. Look for signs of infection, swelling or increased pain. See your doctor if there is no improvement after 48 hours and when signs of infections are noticed.
A basic knowledge on how to manage skin tears is very helpful, not only to manage your own tears but also to help other people who may have it.