Statement of Clinical Problem: Skin tears often cause discomfort for the patient and dressing changes can become a dreaded procedure. The frequency of dressing changes and traumatic dressing removal may be reduced by using modern wound technology.

Description of Past Management: The first patient, an 82 year old female on prednisone, had skin tears to her lower extremities. Past management of the skin tears consisted of antibiotic ointment and gauze. The second individual, a 64 year old dialysis patient with insulin dependent type II diabetes had a skin tear on her foot. Wound management consisted of gauze.

Current Clinical Approach: The management of the first patient's wound included application of a sodium carboxymethylcellulose (CMC) fiber dressing with ionic silver to decrease the chance of infection and to absorb exudate. Since she had such fragile skin and further damage was a concern, a composite dressing that absorbs yet has a gentle adhesive was chosen. Since the second patient also needed a dressing to manage exudate and that had a gentle adhesive, the same product was selected. This combination of dressings provided up to a seven day wear time.

Patient Outcomes: With a protocol of care that included the CMC fiber dressings with ionic silver and the composite dressing with the CMC fibers, the patients healed without difficulty. Both expressed their relief that there was a dressing that was not traumatic upon removal and gentle to their skin.

Conclusions: Skin tears often require a cautious approach because the patients have fragile skin. Dressings with gentle adhesive can manage the wound exudate, require fewer dressing changes, reduce patient discomfort and protect the skin from further damage.