Fay Goode, manager of the Bupa Care Services facility, says staff receive regular training about how to prevent so-called ‘skin tears' and other problems.

This knowledge is also valuable for people at home, including family carers and support workers helping others whose skin is vulnerable because of ageing, inactivity, a chronic illness, or diseases such as diabetes.

We asked Northhaven to share its tips to prevent skin tears, and how to care for these injuries in a home setting.

Common Sense

Last year Northhaven launched a project to reduce skin tear incidents, with great success.

 Band aid finger

Faye says simple, common sense measures can make a big difference, whether you are someone living at home who is prone to skin tears, or supporting someone with fragile skin.

"With ageing, skin can lose its elasticity and becomes very thin and dry, making it especially vulnerable to tears," she says.

"One easy way to keep skin supple is to frequently use moisturiser suited to your skin type."

"It's also important to see a dermatologist if you or the person you support has a chronic skin condition." She says getting a correct diagnosis will help to know how to manage the skin condition, and prevent recurrences or further damage.

Visual Checks

Check skin each day for any scratches, nicks or signs of infection. Consult a doctor or dermatologist if you notice significant changes.

Daily Care

Use moisturiser every day, chosen for the person's skin type (dry, oily, or to treat a particular skin condition). Many elderly people have chronic skin conditions which should be accurately diagnosed by a medical professional, who will recommend how to treat and care for the condition.

Perfumed moisturisers or those containing lots of chemicals can irritate delicate skin. Consider unscented or all-natural products, and gentle soap or soap alternatives such as Pinetarsol.

Be Gentle!

Pat the skin dry with a soft towel after bathing or showering rather than ‘rubbing' the skin. Dry gently and thoroughly, including around any folds of skin, under the breasts, and around the genital area.

Hydration

Everyone needs plenty of fluids each day to keep our bodies hydrated, and our skin supple. Extra liquids are required during the hotter months, so organise regular drinks throughout the day.

Water is the ideal drink; ice blocks are a fun way to increase fluid intake!

Clothing Tips

Many skin tears happen when clothing rubs against the skin, especially during ‘manual handling' such as moving, transferring, dressing and undressing. Clothing should fit loosely and be made from appropriate seasonal fabrics that ‘breathe', such as light cotton during the summer months.

Hot skin gets itchy, which results in rubbing and scratching. Different types of fabric can also irritate sensitive skin (tightly woven polyester, for example), so bear this in mind when choosing clothing.

Avoid tight fitting clothes that don't breathe and will rub, causing chafing, irritation, and (potentially) skin tears.

Nail Care

Keep fingernails short and well groomed (yours and theirs). Long and/or sharp nails can easily catch on fragile skin and cause a significant tear.

Band aid leaf 
Jewellery

Northhaven staff don't wear any jewellery apart from a plain wedding band. This is a good policy to follow at home too.

Watches, bracelets and sharp rings can easily damage vulnerable skin while helping to move and transfer someone at risk of tears.

This can also happen if your own skin is prone to tears while you are in the garden, or performing everyday household tasks.

Manual Handling

When moving someone from a chair to a wheelchair (or vice versa) make sure the chair is positioned at a 90 degree angle to the wheelchair. Ensure the area between the chairs is not cluttered, and that the surrounding area is also clear. Move other furniture out of the way before you move the person. Where possible have soft, round- edged furniture and tables rather than those with sharp edges.

Bumping against furniture corners is a common cause of skin tears and painful bruises.

Wheelchairs

When transferring to a wheelchair, ensure the footrests are well out of the way so ankles and feet don't get knocked. When transporting anyone in a wheelchair, always ensure their feet are sitting on the footrests. Feet can easily slip off the footrests and get caught or knocked. You may want to consider covering the footrests with soft padding or special sheepskin products made for comfort and safety. A soft covering will help to prevent damage to the person's feet and limbs.

Ensure that elbows aren't sticking out from the sides of the wheelchair as you pass through doorways. Always tuck the person's ‘wings' in close to their body to prevent tears and other injuries caused by bumping against doors or furniture.

Bed Transfers

When you move or lift a person while they are in bed you may stretch their delicate skin across the sheet, causing irritation. You can prevent this by using bed sheets made from a slippery fabric (similar to rain coat material, or try satin sheets). Two ‘slippery sheets' used together are ideal to more easily slide the person into position.

Care of the wound

Check daily for redness and signs of infection. Change the nonstick dressing if needed, but don't disturb the wound itself; simply remove the bandage daily to make sure the wound is healing.

Signs of infection

The skin will start to look red or inflamed, may feel warm to touch, and there may be swelling around the wound. Pus or any discharge coming from the wound also indicates an infection. If a tear is treated properly when the injury occurs it is less likely to become infected, but talk to your doctor if signs of infection appear.

When to see a GP

Skin tears can result in a lot of blood which often makes the injury look worse than it is. Usually a skin tear does not need to be seen by a doctor unless the wound is deep, the person is in a lot of pain, or there are signs the wound has become infected.

Depending on the size of the tear, the wound should be healed within a week or so.

If a skin tear occurs

First, try to save the skin. The torn piece can often be very jagged and rolled up - it's very important that you don't cut this skin off, as it can be used to cover the wound, ensuring faster healing and reducing the risk of infection.

Wash your hands before touching the wound. With a peace of wet gauze, try and roll the piece of skin back into place. Flush the exposed wound with plain water - tap water is fine, or boiled water with a little bit of salt dissolved in it. Then, with a second piece of wet gauze, gently ‘roll' the skin back over so that it meets with the wound edges.

Very rarely do you lose much skin. Skin tears can look awful, and there can be a lot of blood. Once you take the time to spread the piece of skin back over the wound it usually fits nicely - like a jigsaw puzzle! You can apply little Steri strips over the wound to keep the skin secure, then lightly bandage.

Don't apply adhesive tape directly to the skin as this can cause pain and more tears when you try to remove the tape. Place a nonstick dressing over the top of the wound, then wrap lightly with a soft crepe bandage. If you or the person you support are prone to skin tears, it pays to keep a supply of these bandaging items at home, so you're prepared if a skin tear does happen. You can buy these from your local chemist.