I am a caregiver for a senior adult friend and the other night I caused a skin tear on the back of her arm above her elbow. It is about an inch long. I initially used Steri-strips on it, but, the next morning they had fallen off so I put one of the clear Tegaderms on it. There doesn’t appear to be any infection, but, I noticed tonight it’s not scabbing.
Does it need to be exposed to air in order to scab?
Just curious…
Is the patient a chronic drinker?
I’ve read that longtime alcoholics have a harder time with blood coagulation.
Bossk, thanks for replying…nope…she’s almost 91 and has never been a drinker.
In general, exposure to air is required (unless you’d be happy with blood coagulating inside your body). OTOH, are you saying that she has an open wound that is still seeping? Or simply that the wound is sufficiently closed that you do not see a scab?
Blood Platelets
(Otherwise, a really depressed economy in conjunction with a labor walkout will generally facilitate scabbing, but it can then be a rather dangerous job choice.)
The wound is not “seeping” as far as I can tell. The Tegaderm is a transparent dressing. I’m not sure I can explain a skin tear to someone who isn’t familiar with them. They are different than anything I have ever seen! She has always healed quickly in the past. I just hope she does the same this time!!
Is she taking aspirin or Aleve, or something in that family? Those medicines are frequently given to help reduce the risk of heart attack, and they relieve arthritis. They also “thin” the blood, so that it doesn’t clot easily. If you want to give blood, the blood center doesn’t want it if you’ve taken such meds in the recent past (I THINK it’s the past 24 hours, not sure though). My mother (re)pierced my ears when I was on naproxen, and I kept bleeding for over 20 minutes. Gave her quite a scare.
Vitamin K has something to do with scabbing, too. I can’t remember whether it facilitates scabbing, or prevents it, and I’m too tired to look it up right now.
All things considered, I’d say to check to see what kind, if any, pain relievers she’s taking.
Lynn, she isn’t on any meds.
I’m gonna take the tegaderm off today and put a steri-strip or two or three on it and see if it will scab.
Vitamin K is required for the synthesis of pro-thrombin, one of the precursors to the final clot. The binding of calcium ions to prothrombin is also required as part of the clotting pathway. Is the patient calcium deficient? That might have something to do with it.
My informants at Google tell me that Tegaderm patches are intended to delay scab formation:
As long as the wound is cleaned thoroughly with an antiseptic, i don’t see why Tegaderm shouldn’t be used. You might want to check with her doctor, though.
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Fortune cookie: Avoid making irrevocable decisions when tired or hungry.