Risk factors and prevention of skin tears

The risk of skin tears is higher in aged skin, though general health and mobility are also contributing factors. A validated risk assessment tool for skin tears is not available; risk factors are divided into modifiable and nonmodifiable categories.

Modifiable risk factors include:

oedema
inadequate nutrition
dehydration
dry skin
medications (corticosteroids, or drugs that contribute to falls or impair balance)
mobility equipment (eg lifters, frames, wheelchairs).

Nonmodifiable risk factors include:

advanced age
history of skin tear
haematoma
impaired mobility
dementia.

Healthcare facilities should develop and implement protocols to optimise patient handling and minimise skin damage during care. Skin tears can be prevented by implementing general preventive measures and addressing patient risk factors. General preventive measures include:

protecting fragile skin with moisturiser (eg QV Cream or Alpha Keri lotion, applied twice a day) and protective garments (eg tubular retention sleeves, stockings, long sleeves or trousers)
drying skin thoroughly (by patting, not rubbing) after washing
careful application and removal of dressings.