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2020 ISTAP Best Practice Recommendations For Holistic Strategies To Promote and Maintain Skin Integrity | Meilleures pratiques recommandées pour des stratégies globales afin de favoriser et maintenir l’intégrité de la peau
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Working Towards a World Without Skin Tears
The International Skin Tear Advisory Panel (ISTAP) is an interprofessional collaboration dedicated to improving outcomes for individuals at risk and/or experiencing skin tears across the continuum of care through education, research & advocacy.
ISTAP raises international awareness of the prediction, assessment, prevention, and management of skin tears. ISTAP comprises a panel of multidisciplinary healthcare professionals representing Africa, Asia, Australia, Europe, Middle East, North America and South America.
What is a skin tear?
“A skin tear is a traumatic wound caused by mechanical forces, including removal of adhesives. Severity may vary by depth (not extending through the subcutaneous layer)”
LeBlanc et al, 2018
A loose flap of tissue can result, and can usually be reapproximated.
Skin tears have a high risk of becoming a complex chronic wound.
Skin tear prevalence rates are equal to or greater than those of pressure ulcers.
Skin tears can occur at any age. This includes the older adult, the critically ill, and pediatric and premature neonatal populations.
Definition of a flap: “A flap in skin tears is defined as a portion of the skin (epidermis/dermis) that is unintentionally separated (partially or fully) from its original place due to shear, friction, and/or blunt force. This concept is not to be confused with tissue that is intentionally detached from its place of origin for therapeutic use e.g. surgical skin grafting” Van Tiggelen et al, 2020
Although commonly associated with the older adult population, skin tears can also occur in the critically ill, pediatric, and premature neonatal populations.
A comprehensive risk assessment should include assessment of the individual’s general health (chronic/critical disease, polypharmacy, and cognitive, sensory, visual, auditory, and nutritional status), mobility (history of falls, impaired mobility, dependent activities, mechanical trauma), and skin (extremes of age, fragile skin, previous skin tears).
The ISTAP Skin Tear Classification System should be utilized to ensure a common language for identifying and documenting skin tears.
In January 2016, ISTAP became an official interest group of Nurses Specialized in Wound, Ostomy and Continence Canada (NSWOCC).