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.
Healthy eating is a topic covered widely in the media, and is particularly relevant to healthcare, with diet and nutrition vital to the management and prevention of many conditions. Wound healing is a complex process that relies on the coordination and internal regulation of activities such as the removal of devitalised tissue and growth of fresh blood vessels. This article examines the phases of wound healing and discusses how nutrients can affect and enhance this process. Understanding the role of nutrients in wound care enables nurses to offer advice to patients whose wounds are not progressing in the expected manner. Nutrition should form part of holistic wound assessment, with any malnourished patient being referred to a dietician. It is a misconception that only underweight individuals can be malnourished and the use of a robust assessment tool will assist nurses in deciding which patients require onward referral. There appears to be a significant link between poor nutrition and delayed wound healing, with a higher risk of complications such as infection identified in malnourished patients
