Surgery Book

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Skin Tear

Aka: Skin Tear, Thin Skin Flap
  1. Epidemiology
    1. Coomon among elderly
  2. Management: General
    1. Cleanse wound well and reapproximate flap
    2. Bandage
      1. Cover site with non-stick pad or Vaseline Gauze
      2. Wrap with gauze roll (avoid skin tape)
      3. Change dressing every 3-5 days
    3. Other measures
      1. Control edema
      2. Avoid Transparent Film Dressing (risk of pulling up flap and skin at time of dressing removal)
  3. Management: Steri-Strip closure technique
    1. Glue steri-strips parallel to wound edges
      1. Suture through the steri strips into skin
      2. Allows for greater strength at wound edge and prevents Suture from tearing through
      3. Pacifico (2009) J Plast Reconstr Aesthet Surg 62(12): e637-8 [PubMed]
    2. Glue steri-strips perpendicular to wound edge, across the Laceration (standard use)
      1. Suture through the steri-strips and traverse the wound as would be done normally
      2. Davis (2011) J Emerg Med 40(3): 322-3 [PubMed]
    3. Precautions
      1. Patient must keep the area clean and dry, and not apply antibiotic ointment to prevent the steri-strips from sloughing
  4. References
    1. Gallentine (2017) Wound Care Update, Park Nicollet Conference, St Louis Park, MN (attended 9/15/2017)

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