Skin tears are a common type of tissue injury, which often go unrecognised and misdiagnosed. Furthermore, classification and documentation of skin is often poor, resulting in chronic wounds with associated adverse patient outcomes. The International Skin Tear Advisory Panel (ISTAP) recently updated the International Best Practice Guidelines and definition of a skin tear based on emerging evidence and expert discussion and consensus. This article presents a discussion of the epidemiology, risk factors and causes of skin tears. In addition, the most recent best practice recommendations for the prevention, assessment, and management of skin tears is summarised.
The suboptimal management of leg ulcers has been identified as a UK-wide problem that involves a high financial and personal cost (Guest et al, 2015). One common omission identified in the care of patients with a leg ulcer is a failure to establish the underlying aetiology of the wound. Ideally, an accurate leg ulcer diagnosis should initiate the appropriate therapy, which should, in turn, facilitate healing; however, an inaccurate diagnosis at the outset means that the patient may not be started on an appropriate management pathway. Although vascular disorders are the major cause of leg ulcers, there are other aetiologies that should be considered when the leg ulcer has failed to respond to evidencebased therapy (Rayner et al, 2009). This article outlines some of the atypical leg ulcer types the author has encountered, as well as detailing the signs that were identified within the assessment process and which allowed the author to formulate an accurate diagnosis.
