HANDI

Interventions

Moisturiser for prevention of skin tears

Other
        1. Moisturiser for prevention of skin tears


Intervention

Twice-daily application of a pH-neutral, perfume-free moisturising lotion to body extremities.

Indication

Skin tears are the most common wounds in elderly people.

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%.

Precautions

Avoid lotion ingredients that may cause irritation such as:

  • urea
  • sodium lauryl sulphate
  • fragrances

Availability

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.

Description

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.

Clinical Resources

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.

Grading

NHMRC Level II

  1. 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.
  2. 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.
  3. 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
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