Skin tear model for reapproximation training

Aim: Skin tears (ST) are common partial or full separation skin wounds found prevalently in elderly patients because of their fragile skin due to abrasion (1). Currently, there is limited assessment awareness and practice equipment, leading to inconsistent management approaches (2). Here, we have developed a polymer-based, sustainable, and cruelty free ST model, which allows practical reapproximation training to improve quality of care.

Methods: ST models were made by tailoring natural polymers that have mechanical properties comparable to human skin. Relative layers resembling fragile epidermis, and weaker dermis were formulated and characterized and the representation of type I, II and III tears were established based on clinician input, also featuring a range of skin tones. Further polymers were then used in specific concentration to mimic subcutaneous layers which was loosely adhered to the skin. Uneven texture and easily disrupted dermal-epidermal junction of the ST model were relevant to clinical practice, involving ST assessment, creation of different tears, cleansing, or debriding necrotic flap if required, and wound edge reapproximation.

Results: Mechanical testing was undertaken to match the mechanical strength which was sufficient to mimic the frail nature of elderly skin. Feedback was provided from multiple sources, including tissue viability specialists, dermatologists, and podiatrists, and models have since been integrated into teaching resources at multiple academic institutions, healthcare trusts and businesses worldwide.

Conclusion: All 3 types of skin tears defined by recognised governing bodies and educational outlets have allowed the practiced of skin tears reapproximation using our ST models. This research offers a low-cost, realistic educational tool to enhance clinical training in skin tear assessment and management, leading to improved patient outcomes and reduced wound care burdens.