When my mom's skin tears were healing I would moisturize, and cover with a non-adherent dressing (like a telfa pad) and seal the edges (only) with silicone tape. There's probably something pre-made available, but I liked how this let me cut to shape and add an extra bit of padding if it was in an area that rubbed. The silicone tape has a secure hold, but won't pull on skin when removing. Moisturizing: Sad but true, I use a lot of Asian beauty products and also use them on my gardening scratches and abrasions. Decided to try them on Mom to keep the 'new' skin supple. I did a moisturizing serum (or one of my heavier overnight 'face pack' lotions) as they seal in moisture like nobody's business. They are geared to be gentle. Not shilling for anyone, but this is what I used if you're interested-These are supposed to be tapped in lightly and a very little goes a long way. The Japanese products tend to be very minimalistic in terms of additives. https://smile.amazon.com/Rohto-Gokujyn-Hyaluronic-Lotion-170ml/dp/B07DMZ76GF/ref=sr_1_18?crid=1OVRJO082TKY1&dchild=1&keywords=hada+labo+hyaluronic+acid&qid=1625150693&sprefix=had%2Caps%2C180&sr=8-18
Not much you can do about skin tears. The skin just becomes too thin. My daughter gave me Steri strips for my Mom. They help to bring the sides of the wounds together so they can heal better. As said maybe a Telfa pad over where Mom gets the tears all the time. Lotions may help with dryness but will not cure the problem.
FIL was covered in these skin tears before he died. I did learn to dress the wounds and one thing I learned was that you have to keep the skin moist with antibacterial ointment and gauze and use those stretchy 'tube socks' to hold the gauze in place. Absolutely NO adhesive strips--you pull those off and have MORE tears.
We did dressing changes 2-3xs a day---and sadly, I was never able to keep up with the new ones, nor did the old ones ever heal. It was a losing battle, but I kept him comfortable, which is all I could hope for.
I had great luck with the Liquid Bandage products. It would seal the skin but also provide a more durable covering that would protect while the skin healed. If there is a way to cushion the hand/wrist or the chest that might be helpful as well. Prevention is better than trying to provide "a band-aid cure" An extra lap blanket maybe or "lambs wool" protector might help. Kinda like that "Sherpa" material A bit off topic but when I had to start giving my Husband Morphine (very small doses) I was actually able to move his hand and arm out of the contracted position for the first time in a while. And he was able to maintain a more relaxed position for a while after medication. For the fact that he was able to relax for the first time in a very long time I was thankful for the Morphine.
As far as moisturizer I would "slather" him after shower or bed bath with a lotion that I would combine with a heavier barrier cream with zinc in it. The one with zinc was very heavy and the lotion seemed not to last long by mixing the 2 I had a creamy lotion that would last most of the day. I would do hands and feet again during the day.
Things to consider that will help with skin integrity:
1 - Only use a soap that is pH balanced. If your patient is older, try a cleansing lotion - one with moisturizers - rather than straight soap which can strip skin oils.
2 - Make sure to dry his/her skin well before applying lotion.
3 - I like lotions that contain jojoba or shea, but baby lotion can work well too. Use them after cleansing the skin and a couple of times during the day is skin is dry.
4 - If the person tends to get sweaty, crumbly skin, then moisture is a problem. Try to get the "sweaty areas" opened up a couple of times a day. Use passive range of motion exercises. Sometimes it helps to put a clean dry washrag into areas where skin meets skin.
5 - Sounds like part of the problem is also "friction." Try to reduce friction by covering the areas that rub with clothing. The wrist might do better with a wrist band, something like a smooth knit sock, that keeps the skin on the wrist from rubbing against anything.
I didn’t see this coming but logically it makes sense. Thanks for the questions and replies. I‘ ll be more diligent with my Mom as time passes. The last time she was in the ER I saw how painful pulling the bandages and adhesives had become. I’ll know to ask for alternatives now to head off the issue.
Skin breakdown is caused by pressure and moisture. Eliminate the moisture with Calmoseptine. It can be ordered through Amazon. This oinntment has Zinc Oxide and is excellent for helping heal pressure sores and wounds on bed bound patients.
Calmoseptine is a great product along with a Gel sock with the toes cut out.....If you can get it over the contraction put the gel heel where the wrist rubs.
This what we use for my dad every time he gets a new place. I then put gauze over with paper tape. Its easy on the skin. Calmoseptine is great. Sometimes I put some Desitin over the Cal.
If this question is about wounds, then a Wound Care consult is preferred since most care with breakdown is more about not just the skin, but nutrition, hydration and pressure. Unless you are a wound care expert which is a specialized nurse, or physician, I would not ask this question and get replies to follow, you can do more damage not knowing what type of wound is really there and risk of infection to point of growing more bacteria. Would advise to seek medical attention for this wound, and requesting Dressing Changes. Once you have the reason why this is likely the case of will it heal or not, then you can be taught how to care for it, otherwise you can accelerate a problem putting wrong creams or ointments on skin that might be breaking down due to poor nutrition. Skin breakdown is more than placing a covering.
I've been using Virgin Coconut Oil on my 97 yr old Dad for 2 yrs and it works awesome. I use Butt Paste on his butt and he's never had a bed sore. But my Dad's skin is Super thin so if he had an area like your talking about, I would let him wear 100% Cotton long sleeve T Shirts to help protect his skin.
I would have LOVED to have access to a Wound Care specialist. As it was, and I think this holds true for a LOT of people, you get ONE visit from a CNA and bag of supplies and you never see them again.
I remember going over to FIL's at 8 am and finding pools of blood where he'd fallen and I'd have to check him over to find out WHERE he'd scraped skin this time. I ended up buying him supplies as what the wound care team left lasted less than a week and then they were in the wind.
I was not allowed to even use steri strips--as gentle as those are---even I have scars where some steri strips were pulled off.
For sure, this is a real daily problem with no 'one size fits all' solution.
Add to that, I gloved up for each and every wound change. There sat DH on the sofa, retching b/c he was so grossed out--and I'm really trying to keep FIL calm.
Also, it was HOT and FIL refused to turn on his A/C, so I let him sit in the recliner with no shirt on and a window open. I don't know to this day if I helped or hurt him---
My moms arm is contracted and on her belly a lot as well. sometimes I will use a piece of foam dressing and either use curling gauze wrap around it or I use allevyn life bandages (they have a pink very delicate border and are easy on the skin). Sometimes I even put a piece of the curafoam on her belly (u can cut to size) where her left hands lays so she doesn’t have pressure on her belly. and it give a little cushioning. We just finished wound care on her arm with adaptic tape first - then small amount betadine on gauze and then wrapped with curling gauze - that was her wound care drs orders. The adaptic tape helps the gauze not stick to the new fragile skin.
Protecting the spot from getting hit or rubbed is about all you can do.
https://www.amazon.com/Heel-Elbow-Protectors-Eggcrate-Standard/dp/B002HYR5VY
Moisturizing: Sad but true, I use a lot of Asian beauty products and also use them on my gardening scratches and abrasions. Decided to try them on Mom to keep the 'new' skin supple. I did a moisturizing serum (or one of my heavier overnight 'face pack' lotions) as they seal in moisture like nobody's business. They are geared to be gentle. Not shilling for anyone, but this is what I used if you're interested-These are supposed to be tapped in lightly and a very little goes a long way. The Japanese products tend to be very minimalistic in terms of additives.
https://smile.amazon.com/Rohto-Gokujyn-Hyaluronic-Lotion-170ml/dp/B07DMZ76GF/ref=sr_1_18?crid=1OVRJO082TKY1&dchild=1&keywords=hada+labo+hyaluronic+acid&qid=1625150693&sprefix=had%2Caps%2C180&sr=8-18
We did dressing changes 2-3xs a day---and sadly, I was never able to keep up with the new ones, nor did the old ones ever heal. It was a losing battle, but I kept him comfortable, which is all I could hope for.
It would seal the skin but also provide a more durable covering that would protect while the skin healed.
If there is a way to cushion the hand/wrist or the chest that might be helpful as well. Prevention is better than trying to provide "a band-aid cure"
An extra lap blanket maybe or "lambs wool" protector might help. Kinda like that "Sherpa" material
A bit off topic but when I had to start giving my Husband Morphine (very small doses) I was actually able to move his hand and arm out of the contracted position for the first time in a while. And he was able to maintain a more relaxed position for a while after medication. For the fact that he was able to relax for the first time in a very long time I was thankful for the Morphine.
As far as moisturizer I would "slather" him after shower or bed bath with a lotion that I would combine with a heavier barrier cream with zinc in it. The one with zinc was very heavy and the lotion seemed not to last long by mixing the 2 I had a creamy lotion that would last most of the day. I would do hands and feet again during the day.
1 - Only use a soap that is pH balanced. If your patient is older, try a cleansing lotion - one with moisturizers - rather than straight soap which can strip skin oils.
2 - Make sure to dry his/her skin well before applying lotion.
3 - I like lotions that contain jojoba or shea, but baby lotion can work well too. Use them after cleansing the skin and a couple of times during the day is skin is dry.
4 - If the person tends to get sweaty, crumbly skin, then moisture is a problem. Try to get the "sweaty areas" opened up a couple of times a day. Use passive range of motion exercises. Sometimes it helps to put a clean dry washrag into areas where skin meets skin.
5 - Sounds like part of the problem is also "friction." Try to reduce friction by covering the areas that rub with clothing. The wrist might do better with a wrist band, something like a smooth knit sock, that keeps the skin on the wrist from rubbing against anything.
I use Butt Paste on his butt and he's never had a bed sore.
But my Dad's skin is Super thin so if he had an area like your talking about, I would let him wear 100% Cotton long sleeve T Shirts to help protect his skin.
I remember going over to FIL's at 8 am and finding pools of blood where he'd fallen and I'd have to check him over to find out WHERE he'd scraped skin this time. I ended up buying him supplies as what the wound care team left lasted less than a week and then they were in the wind.
I was not allowed to even use steri strips--as gentle as those are---even I have scars where some steri strips were pulled off.
For sure, this is a real daily problem with no 'one size fits all' solution.
Add to that, I gloved up for each and every wound change. There sat DH on the sofa, retching b/c he was so grossed out--and I'm really trying to keep FIL calm.
Also, it was HOT and FIL refused to turn on his A/C, so I let him sit in the recliner with no shirt on and a window open. I don't know to this day if I helped or hurt him---
sometimes I will use a piece of foam dressing and either use curling gauze wrap around it or I use allevyn life bandages (they have a pink very delicate border and are easy on the skin). Sometimes I even put a piece of the curafoam on her belly (u can cut to size) where her left hands lays so she doesn’t have pressure on her belly. and it give a little cushioning.
We just finished wound care on her arm with adaptic tape first - then small amount betadine on gauze and then wrapped with curling gauze - that was her wound care drs orders. The adaptic tape helps the gauze not stick to the new fragile skin.