Skin tears are the most common wound type in the elderly. Critical health issues can occur at any age, but those over 65 are more susceptible to thinning/fragile, bruised skin that upon impact or minor trauma can result in painful and dangerous tears.
In the United States, reports from 2011 state that 1.5 million skin tears occur per year in institutionalized adults. It is likely that the occurrence of skin tears at home is much higher, as more seniors choose to age-in-place. By 2030, it is estimated that 1 out of 5 people in the U.S. will be over 65. Baby boomers’ elder-care experiences will make quality of life and remaining at home an important life choice for this generation and those to come.
Causes of Skin Tears
As we age, the physiological changes to the skin result in thinning and fragility. Skin loses protective layers of fat and the production of collagen slows. UV light damages it further. “Senile purpura,” also known as blood spots or skin hemorrhages—those purple spots found most commonly on the arms and back of hands—are pooled blood under thin skin and are the most common cause of skin tears. Malnutrition and medications—blood thinners and corticosteroids—reduce the strength and elasticity of skin. Chemotherapy and dermatological disorders also affect skin integrity.
The outside forces most common in contributing to trauma-induced skin tears are wheelchair and hospital bed transfers, routine daily activities such as bathing and dressing, intravenous catheters, friction from medical devices, impacts from falling or bumping into furniture and the obvious threat from long fingernails and toenails.
Depending on one’s general health, skin tears may take a long time to heal and require close monitoring by a family caregiver or health care professional, resulting in restriction of daily activities we take for granted. This presents challenges for those who wish to remain safe at home and prevent skin injuries while doing so.
Maintaining Skin Integrity
What preventive measures can be implemented? Caregivers are vital to the management and prevention of skin tears. It is important to create a safe environment, provide proper nutrition and hydration, maintain skin lubrication and keep nails short on both patient and caregiver, while ensuring no one wears jewelry.
Limb protection products offer important features such as noncompression, breathability, softness, ease of use (no fasteners), moisture management and antimicrobial properties. These products also give the mobile senior more confidence to continue daily activities, as they offer protection from scrapes and bruises.
The bottom line—skin tears need special attention. Taking preventive measures to maintain skin integrity and provide a healing environment will help seniors age-in-place safely.