Funding Body

Smith&Nephew ($30,000)
School of Nursing, Curtin University of Technology ($3,000)

Project Description

Anecdotally skin tears are described as the second most common wound found on older disabled or physically unwell people (pressure ulcers being the first).  While skin tears do not usually cause serious health problems for the individual, they do disrupt the integrity of the skin, predispose to infection, can be the source of physical and emotional discomfort, and their treatment can be costly. In order to quantify the extent of this problem for older people and to ensure that best practice prevention and treatment protocols exist and are implemented, it is necessary to ensure that we have a common language to describe these wounds.

There is currently no universally accepted definition of a skin tear. Nevertheless there is a skin tear classification, the Payne Martin, but its usefulness and validity have received little attention, and it is not commonly used in Australia.

This project involves a large collaborative research program with Curtin University’s School of Nursing and Midwifery which has the ultimate goal of reducing the numbers of skin tears on older persons by implementing effective prevention and treatment programs across different care settings.  Stage 1 involved the development of a refined classification of skin tears.

Project Update

Stage 1 was completed in early 2007 and resulted in a consensus for skin tear classification between a group of Australian wound management experts. The resultant STAR Classification System (see below)  was tested and found to be simple and  easy to use and the process undertaken to achieve consensus has been published (see below) and presented at National and International Wound management conferences.
The tool has been used in two state-wide wound prevalence surveys and has been widely utilised across Australia (after being made freely available for use by other organisations) in all heath care sectors. Anecdotal feedback has been very positive regarding its utility.

Stage  2 will involve a case control study to identify and rank the predictors for skin tear acquisition in a Western Australian tertiary hospital. Funding has been secured for this next stage of the STAR project and preliminary planning is occurring and we hope to start data collection by the end of 2008.  It is hoped that the results of this stage of the study will then inform the third stage which will involve the development of a skin tear risk prediction tool and risk management guidelines for use in hospital, aged care and community settings.

Publications

STAR: A consensus for skin tear classification, February 2007 [PDF]
Carville, K., Lewin, G., Newall, N., Haselhurst, P., Michael, R., Santamaria, N., Roberts, P. 2007. STAR: A consensus for skin tear classification. Primary intention 15(1): 18-28.

STAR: Skin Tear Tool  - Latest Version - 15/01/07 [PDF]
For permission to use or reproduce the STAR tool please contact NNewall@silverchain.org.au or kcarville@silverchain.org.au

Related Links

Wound Care Manual
An up to date practical guide for the management of all types of wounds.

For further information please contact
Nelly Newall
Clinical Research Co-ordinator
Email  NNewall@silverchain.org.au