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Risk Factors Associated with Skin Tear Development in the Canadian Long-term Care Population
Kimberly LeBlanc1, Kevin Y Woo, Elizabeth VanDenKerkhof
1Kimberly LeBlanc, PhD, RN, NSWOC, is Chair, Wound, Ostomy and Continence Institute; Adjunct Professor, MClSc Program, School of Physical Therapy, Faculty of Health Sciences, Western University; and Affiliate Faculty, Ingram School of Nursing, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. Kevin Y. Woo, PhD, RN, NSWOC, FAPWCA, is Associate Professor, School of Nursing, Queen's University; and Adjunct Professor, MClSc Program, School of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario. Elizabeth VanDenKerkhof, DrPH, RN, is Professor and Sally Smith Chair in Nursing, School of Nursing, Queen's University, Toronto. M. Gail Woodbury, PhD, is Adjunct Assistant Professor, School of Rehabilitation Therapy, Queen's University. The authors have disclosed no financial relationships related to this article. Submitted October 20, 2019; accepted in revised form December 10, 2019; published ahead of print October 6, 2020.
Background:
Skin tears (STs) are prevalent wounds found in aging populations and in particular among those living in long-term care (LTC) settings. They are often misunderstood as expected outcomes of aging and as a result are frequently underrecognized and undertreated. Although many factors have been associated with ST development, there is little evidence to corroborate their roles as ST risks.
Objective:
To examine the risk factors associated with ST development in the Ontario LTC population.
Methods:
A prospective study design was used to explore the risk factors associated with ST development. A total of 380 individuals 65 years or older from four LTC facilities in Ontario were examined for STs at the beginning of the study and at week 4 to determine if STs had occurred.
Results:
The study found an ST prevalence of 20.8% and an incidence of 18.9%. History of an ST at baseline (relative ratio [RR], 1.84; 95% confidence interval [CI], 1.25-2.70; P = .002); the presence of skin changes associated with aging, ecchymosis, and hematomas (RR, 1.60; 95% CI, 1.43-1.79; P < .001); chronic disease (RR, 1.17; 95% CI, 1.03-1.32; P = .018); requiring assistance with activities of daily living (RR, 1.13; 95% CI, 1.08-1.18; P < .001); and displaying aggressive behavior (RR, 1.06; 95% CI, 1.02-1.10; P = .001) were key risk factors associated with ST development.
Conclusions:
These results provide much needed Ontario data on the risk factors associated with ST development and can be used to support prevention programs mitigating ST risk.
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