Introducing a new validated Skin Tear Classification System

The appropriate management of patients with skin tears is an ongoing challenge for healthcare professionals. Skin tears are painful, acute wounds resulting from trauma to the skin and are largely preventable.  Despite preliminary studies that suggest skin tears may be more prevalent than pressure ulcers, there remains a paucity of literature to guide prevention, assessment, and treatment of skin tears. Payne and Martin (1993) established a classification system however it failed to become universally accepted and an international survey by LeBlanc and Baranoski (2010) indicated that healthcare professionals would like a more simplistic classification system.

In an effort to shift awareness towards this largely unheeded healthcare issue, an International Skin Tear Advisory Panel (ISTAP) was established. 13 internationally recognized key opinion leaders convened to establish consensus statements on the prevention, prediction, assessment and treatment of skin tears. The initial ISTAP meeting was held in January 2011, and was made possible by an unrestricted educational grant from Hollister Wound Care Inc. The meeting resulted in the development and publication of 12 key consensus statements and a definition for skin tears.

A follow up ISTAP meeting in December 2011, resulted in the development of a new classification system building on the work of Payne and Martin (1993). The ISTAP Skin Tear Classification System was validated for internal, external and intra-reliability with 86% agreement.  Kappa testing was conducted according to the Landis and Koch interpretation and demonstrated substantial agreement (Fleiss Kappa =0.619).

The development of a universally accepted classification system for skin tears is an important first step towards developing international guidelines for the prevention, prediction, assessment and management of skin tears. It is essential that these wounds be distinguished from other wound types in order to reach this goal and to raise the global awareness of these unique wounds.