Sharon Baranoski

Skin tears: state of the science: consensus statements for the prevention, prediction, assessment, and treatment of skin tears©.

The appropriate management of patients with skin tears is an ongoing challenge for healthcare professionals. Skins tears are often painful, acute wounds resulting from trauma to the skin and are largely preventable. Healthcare professionals must be able to identify individuals at risk for skin tears and aid in the prevention of these wounds and in their treatment when they occur. Despite preliminary studies that suggest skin tears may be more prevalent than pressure ulcers, there remains a paucity of literature to guide prevention, assessment, and treatment of skin tears. As a result, these wounds are often mismanaged and misdiagnosed, leading to complications, including pain, infection, and delayed wound healing. In addition, skin tears increase caregiver time and facility costs, cause anxiety for patients and families, and may reflect poorly on the quality of care delivered in a facility. In an effort to shift awareness toward this largely unheeded healthcare issue, a consensus panel of 13 internationally recognized key opinion leaders convened to establish consensus statements on the prevention, prediction, assessment, and treatment of skin tears. The initial consensus panel meeting was held in January 2011 and was made possible by an unrestricted educational grant from Hollister Wound Care. This document details the consensus definition and statements, as well as recommendations for future research and steps toward establishing a validated, comprehensive program for managing skin tears.

Guidelines for managing pressure ulcers with negative pressure wound therapy.

Pressure ulcers are a serious health issue, leading to clinical, financial, and emotional challenges. Numerous treatment modalities are available to promote wound healing, yet clinicians may be unsure how to incorporate these treatment options into an overall plan of care for the patient with a pressure ulcer. A consensus panel of experienced wound care clinicians convened in July 2004 to review the mechanisms of action and research basis for one such treatment modality: negative pressure wound therapy. After answering key questions about this modality, they developed an algorithm to assist the clinician in making decisions about using negative pressure wound therapy appropriately in patients with Stage III and Stage IV pressure ulcers.

International Skin Tear Advisory Panel: A Tool Kit to Aid in the Prevention, Assessment, and Treatment of Skin Tears Using a Simplified Classification System©

PURPOSE To enhance the learners competence with knowledge regarding utilization of a tool kit to aid in the prevention, assessment, and treatment of skin tears. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES After participating in this educational activity, the participant should be better able to:1. Demonstrate knowledge of skin tear prevention and classification as presented in the International Skin Tear Advisory Panels tool kit.2. Apply information from the skin tear tool kit to patient care scenarios. ABSTRACT The International Skin Tear Advisory Panel has created a tool kit for the prevention, identification, and treatment of skin tears. The tool kit is based on extensive literature reviews, international input from healthcare professionals, and on expert opinion. It has undergone a modified Delphi process.

Prevention and Management of Skin Tears

PURPOSE To provide the wound care practitioner with evidence-informed information on the prevention and management of skin tears. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES After reading this article and taking this test, the reader should be able to: Identify risks and causes of and a classification system for skin tears. Discuss the treatment and prevention of skin tears.

Validation of a new classification system for skin tears.

OBJECTIVE: The aim of this study was to validate and establish reliability of the International Skin Tear classification system. METHOD: A consensus panel of 12 internationally recognized key opinion leaders convened in 2011 to establish consensus statements on the prevention, prediction, assessment, and treatment of skin tears. Subsequently, a new skin tear classification system was proposed. The system was then tested for interrater and intrarater reliability between the experts before being tested more widely on a sample of 327 individuals from the United States, Canada, and Europe. RESULTS: The results of the study indicated a substantial level of agreement for the expert panel (Fleiss &kgr; = 0.619; 2-month follow-up = 0.653). Intrarater reliability was high (Cohen &kgr; = 0.877). Interrater reliability was moderate (Fleiss &kgr; = 0.555) for healthcare professionals (n = 303) and fair for non–health professionals (Fleiss &kgr; = 0.338; n = 24). CONCLUSIONS: This international study established the reliability and validity of a new classification system for skin tears.

Wound dressings: an evolving art and science.

Keeping abreast of the numerous wound dressings available for patient care is an ambitious task. Being able to differentiate among the various treatment options, when and how to apply them, in what combinations, and when to change them has become a challenge for all healthcare practitioners.

Raising awareness of pressure ulcer prevention and treatment.

PURPOSE To provide the practitioner with updated information about pressure ulcers and their management. TARGET AUDIENCE This continuing education activity is intended for physicians and nurses with an interest in better understanding the scientific principles governing pressure ulcer development and treatment. OBJECTIVES After reading this article and taking this test, the participant should be able to: 1. Discuss the etiology and assessment of pressure ulcers. 2. Describe treatment options for pressure ulcers.

A descriptive cross-sectional international study to explore current practices in the assessment, prevention and treatment of skin tears

This study presents the results of a descriptive, cross‐sectional, online international survey in order to explore current practices in the assessment, prediction, prevention and treatment of skin tears (STs). A total of 1127 health care providers (HCP) from 16 countries completed the survey. The majority of the respondents (69·6%, n = 695) reported problems with the current methods for the assessment and documentation of STs with an overwhelming majority (89·5%, n = 891) favouring the development of a simplified method of assessment. Respondents ranked equipment injury during patient transfer and falls as the main causes of STs. The majority of the samples indicated that they used non‐adhesive dressings (35·89%, n = 322) to treat a ST, with the use of protective clothing being the most common method of prevention. The results of this study led to the establishment of a consensus document, classification system and a tool kit for use by practitioners. The authors believe that this survey was an important first step in raising the global awareness of STs and to stimulate discussion and research of these complex acute wounds.

Skin tears: staying on guard against the enemy of frail skin.

Skin tears are a serious, painful problem for your older patients. Find out how to recognize patients at risk, what you can do to prevent skin tears, and how to manage them effectively if they occur.

The Art of Dressing Selection: A Consensus Statement on Skin Tears and Best Practice.

PURPOSE: To provide information about product selection for the management of skin tears. TARGET AUDIENCE: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. OBJECTIVES: After participating in this educational activity, the participant should be better able to: 1. Explain skin tear (ST) risk factors and assessment guidelines. 2. Identify best practice treatments for STs, including the appropriate dressings for each ST type. ABSTRACT To aid healthcare professionals in product selection specific for skin tears, the International Skin Tear Advisory Panel conducted a systematic literature review and 3-phase Delphi consensus with a panel of international reviewers to provide the best available evidence for product selection related to the treatment of skin tears.