Effectiveness of moisturiser for the prevention of skin tears in older adults residing in long-term care facilities: a clinical review

In long-term care (LTC) facilities, treatment of skin tears often takes a lot of nursing time, is costly and can negatively impact on the quality of life of residents. While skin tears may not be life-threatening, they are a painful injury that can also be disfiguring (Fleck, 2007). Skin tears can sometimes become infected, which can cause more suffering to the residents (Rayner et al, 2015). There is a general interest towards reducing skin tears, but often, what is seen as a reasonable action—for example the use of moisturisers—may not be supported by an evidence-base. There is an ongoing demand for LTC providers to practice using evidence-based guidelines to improve delivery of the quality of care.

Ageing is associated with structural and functional changes of the skin that result in increased vulnerability (Kottner et al, 2013). A healthy skin provides the primary protection for the body against external injuries and is essential in the maintenance of general homeostasis (Bonté et al, 2019). Thinning, reduced elasticity and other age-related changes of the dermis and epidermis (chronological ageing), as well as sun damage (photoaging), change the skin's ability to resist damage and injury, such as a skin tear (Koyano et al, 2016; Bonifant and Holloway, 2019).