Skin Tears

Each year in the United States, about 1.5 million people experience skin tears—acute wounds caused by “shearing” or friction forces. 

The resulting wound is either a linear slash, or a wound bed of largely intact tissues covered, in part, by a loose flap of skin. 

This guide details how to recognize and assess different types of skin tears, and how to threat them in accordance with best practices,

What Are Skin Tears?

The International Skin Tear Advisory Panel (ISTAP) defines a skin tear as “a traumatic wound caused by mechanical forces, including removal of adhesives.” 

Specifically, they’re skin injuries “which separate the epidermis from the dermis (partial thickness wounds) or which separate both the epidermis and the dermis from underlying structures (full thickness wounds).”

Skin tears are classified by severity, which varies. Serious skin tears demand emergency medicine, while milder tears can be treated by first aid at home. 

Skin Tears (Avulsion Wounds) Vs. Skin Micro-Tears 

Skin tears are serious injuries. Also called avulsion wounds, these injuries tear a layer or flap of skin away from the rest of the body. 

At their most severe, skin tears require skin grafts or similar surgical treatment. 

In contrast, micro-tears in skin are not serious. Nor are they typically classified as injuries. Unlike avulsive skin tears, micro tears are barely visible to the naked eye. 

These “tears” are tiny, irritating abrasions that typically only cause itchiness or mild inflammation. They’re often caused by using harsh skin exfoliants. 

How To Treat Skin Tears 

In 2018, ISTAP published a best practices document, detailing optimal skin tear treatment and prevention protocols. In partnership with Wounds International, ISTAP’s guide reflects the consensus among medical professionals worldwide. 

It is strongly recommended that anyone treating skin tears read the detailed guide in full. 

1. Staunch & Control Bleeding 

Bleeding can usually be controlled by applying direct pressure to the wound with a clean cloth or gauze. Use dressings as needed to facilitate haemostasis. Observe for any signs of a hematoma.  

2. Clean Wound With Appropriate Cleanser 

It’s important to only clean the wound with an appropriate, skin-safe agent. Do not use soap, hydrogen peroxide, alcohols, hot water, or any abrasive cloth. 

Instead, use mildly warm, sterile water or saline, and a non-abrasive, bio-compatible cleanser (like a diluted hypochlorous acid solution). Use a syringe to irrigate the wound with saline, gently. Remove any debris or hematoma clotting. 

3. Roll Loose Skin Tissues Into Optimal Healing Position

If there are intact skin flaps, and they are not necrotic, use the skin flap like a dressing. Using gloves or a silicone strip, gently set the skin flap in place over the wound bed. 

4. Assess Wound (STAR Classification) & Healing Factors

At this step, assess the wound. Consider other factors that could speed or impede healing. 

If the wound has not stopped bleeding after applying pressure for ten minutes, bleeding doesn’t slow after three minutes, the exposed wound bed is wide or deep, or there are any signs of infection, go to the emergency room. 

5. Dress Wound In Alignment With Skin Flap

Dress the skin tear with an appropriate gauze or foam. Dressings should manage exudate, maintain an appropriately hydrated wound environment, prevent infection, alleviate pain and inflammation, and facilitate healing. 

Use skin barriers to prevent maceration of peri-wound skin. Consider negative wound pressure therapy or compression therapy. 

Most skin tears follow a standard wound closure trajectory, typically healing in 2-3 weeks. If the healing rate is slower, or if there is visible pus, discoloration, fevers, or other signs of infection, seek urgent medical attention.  

The Best Dressings For Skin Tears (Treatment)

ISTAP recommends nine types of skin tear treatment products, noting the best use case for each type, in Table 2 of their best practices document. The most widely-applicable options include:

• Non-adherent mesh dressings
  • Impregnated-petrolatum mesh gauze
  • Silicone mesh
  • Lipocolloid mesh
• Silicone foam dressings
• Cyanoacrylate-based skin protectants
• Calcium alginates

The right dressing choice depends on the wound’s moisture level, position, and depth (among other factors). 

Non-Adherent Mesh Dressings

Non-adherent mesh dressings are effective across the severity spectrum. There are several well-reputed options available.

Xeroform For Skin Tears (Non-Occlusive Gauze)

Xeroform dressings are impregnated with Petrolatum and 3% Bismuth Tribromopenate. The Xeroform Non-occlusive Gauze Dressing is adhesive-free and delivers mild, soothing medication on wound contact. 

Silicone Mesh (Wound Contact Layer)

Silicone is a biocompatible material. Mesh dressings like the Atrauman Silicone Wound Contact Layer are skin-safe and breathable. 

Silicone is similarly safe and effective as a foam dressing. 

Shop Wound Treatment & Prevention Supplies At Medical Monks

Medical Monks offers a wide range of curated wound care supplies. Shop our selection of advanced dressings today.