Skin tears are the most common wounds in elderly people
Twice-daily application of a pH-neutral, perfume-free moisturising lotion to body extremities.
Prevention of skin tears in frail elderly patients. The majority of skin tears in these patients occur on the arms (54%) and legs (40%).
Moisturising the skin of elderly people reduces the incidence of skin tears by almost 50%.
Avoid lotion ingredients that may cause irritation such as:
- sodium lauryl sulphate
The lotion used in the trial is Abena® Skincare Lotion Unscented, which costs around A$13 for 500 ml. Other similar lotions may be used.
The lotion should:
- be pH neutral
- contain a non-irritating humectant (eg glycerine)
- contain an occlusive agent (eg paraffin or plant oil).
Similar available lotions include Cetaphil® Moisturising Lotion, Cetaphil® Daily Advance Lotion, Alpha Keri® Skin Moisture Boost Lotion and QV® Skin Lotion. These may be purchased from pharmacies, supermarkets and online.
Lotion is applied twice daily to the extremities in a gentle downward direction, preferably after bathing. It may be applied by patients (if able) or carers.
Tips and Challenges
This is cost-effective and simple therapy should be considered for all patients at risk of skin tears.
Other strategies that may reduce skin tears include safe handling training, falls prevention. long-sleeved clothing, shin protectors and good nutrition.
QV Skin Tear Prevention Program: a toolkit for clinicians to implement a skin tear prevention program in aged care facilities.
* The RACGP and the HANDI team do not endorse QV over any other moisturiser broadly matching the description in the topic text.
NHMRC Level II
Carville K, Leslie G, Osserian-Moisson R, Newall N, Lewin G. The effectiveness of a twice-daily skin-moisturising regimen for reducing the incidence of skin tears. Int Wound J 2014;11(4):446–53.
LeBlanc K, Kozell K, Martins L, et al. Is twice daily skin moisturizing more effective than routine care in the prevention of skin tears in the elderly population? J Wound Ostomy Continence Nurs 2016;43(1):17–22.
Hunter S, Anderson J, Hanson D, et al. Clinical trial of a prevention and treatment protocol for skin breakdown in two nursing homes. J Wound Ostomy Continence Nurs 2003;30(5):250-258