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SkinTear Case Study: Vernon, T

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Intrasite Conformable in the treatment of a skin tear


Tracy Vernon, BA (Hons), RGN., CNS - Tissue Viability, Doncaster Royal Infirmary

 

Introduction
Skin tears are frequently seen in elderly patients and can prove to be challenging for the nurse to manage effectively. When managing a patient with a skin tear it is crucial that the dressing selected does not adhere to the wound causing further damage to skin that is friable and susceptible to tissue damage. The patient, an elderly lady of 80 years was admitted into an acute medical ward with numerous medical problems. While she was in hospital she sustained a large skin tear whilst getting out of bed. The area measured 8cm in length by 6cm in depth. The nursing staff referred the patient to the Clinical Nurse Specialist for further management (see figure 1).


The nursing challenge
Manage a large skin tear on a patient who has poor quality skin.

 

Nursing aims

  • To use a wound care product which would stay in contact with the wound, hence providing the optimum environment for wound healing
  • To use a dressing which would be easy to remove
  • To use a dressing which would not cause any further damage to the patient's fragile skin
  • To select a secondary dressing which would enhance the properties of the primary dressing

 

Nursing interventions
Having being able to replace the skin flap over the area of skin damage (see figure 2) the key aim was to provide the optimum environment for wound healing to take place. INTRASITE Conformable was chosen as the dressing of choice for the lady's management.


This product was selected as being the most appropriate, as by using a non woven dressing impregnated with INTRASITE Gel a moist, warm environment can be achieved. The INTRASITE dressing was opened out and layered on over the wound in order to maximise the amount of Intrasite that was in contact with the wound (figure 3). ALLEVYN™ Hydrocellular was then applied over the INTRASITE Conformable as a secondary dressing followed by a bandage to secure. The rationale for the choice of the secondary dressing was to make sure that no adhesive products were placed on the patient's friable skin.


Outcome
The dressings were removed as per the manufacturer's instructions on the third day (figure 4). The dressing was easy to remove, did not cause any trauma to the wound, and the patient did not experience any pain at all. Figure 5 shows the woundten days later when the INTRASITE Conformable was removed allowing the ALLEVYN Hydrocellular dressing to be applied for protection.

 

Figure 1 Figure 2 Figure3
Figure 1 Figure 2 Figure 3
Figure4 Figure 5
Figure 4 Figure 5