ISTAP classification for skin tears: Validation for Brazilian Portuguese.

Area of Science:

• Nursing
• Dermatology
• Clinical Assessment

Background:

• Skin tears (STs) are common, particularly in vulnerable patient populations.
• Accurate classification of STs is crucial for effective management and treatment.
• The International Skin Tear Advisory Panel (ISTAP) Skin Tear Classification System requires validation for diverse linguistic and clinical contexts.

Purpose of the Study:

• To evaluate the interobserver reliability of the adapted ISTAP Skin Tear Classification System in Brazilian Portuguese.
• To assess the concurrent criterion validity of the adapted ISTAP system against the STAR Classification System.
• To determine the clinical utility of the adapted ISTAP system for Brazilian healthcare professionals.

Main Methods:

• Interobserver reliability was assessed using a photograph database (36 nurses, 30 STs) and clinical application (23 nurses, 12 STs).
• Concurrent criterion validity was evaluated by comparing the adapted ISTAP system with the STAR Classification System in postoperative patients.
• Statistical analyses included Fleiss kappa for photographic data and correlation coefficients for clinical data.

Main Results:

• Photographic assessment showed reasonable interobserver reliability (Fleiss κ = 0.279).
• Clinical application demonstrated higher interobserver reliability (76.7% correct answers).
• Concurrent criterion validity was confirmed with a perfect correlation (r = 1) between the ISTAP and STAR systems.

Conclusions:

• The adapted ISTAP Skin Tear Classification System demonstrates acceptable reliability and validity in the Brazilian context.
• This validated instrument provides a valuable additional tool for skin tear classification in Brazilian clinical practice.
• The findings support the adoption of the ISTAP system for standardized skin tear assessment in Brazil.