Recent publications include:
A Review of the Skin Failure Concept
This new manuscript reviews barrier functions of skin and defines specific pathophysiologic factors that lead to its disruption including hypoperfusion, hypoxia, increased vascular permeability, and edema – all of which act synergistically. The article further defines acute and chronic conditions leading to these pathophysiologic aberrations including Multiple Organ Dysfunction Syndrome (MODS), protein-calorie malnutrition, and immunocompromised states. Also addressed are critical contributing factors such as age-related skin changes, frailty, sarcopenia, cytoskeletal and external forces, pharmacologic contributors, and the dying process.
Medical Device Related Pressure Injury to the Ear due to Mask
The ear is a convenient anchor for a mask, which renders it subject to constant pressure and friction from the elastic band. Diagnosis of injuries in the postauricular area may be missed or delayed because it is hidden behind the ear and/or covered with hair. Pressure injury to the ear can result in pain, infection, scarring, or permanent deformity.
New Review on Aging Skin, with Considerations for Clinicians
My review article entitled Clinical Aspects of Aging Skin is now online in the January edition of Advances in Skin & Wound Care, and is available on line at this link. This article is filled with practical information for the wound care practitioner, but does...
Terminal Ulcer Terminology Reconsidered
My new article in Wound Management & Prevention is a critical re-examination of terminal ulcer terminology. In it I make the case for recognizing terminal ulcers as part of the spectrum of skin failure (and not necessarily heralding death) and used only in...
Wound Care: What the Medical Director Needs to Know
This article was published in Caring For the Ages, a journal sponsored by the American Medical Directors Association (AMDA) - the Society for Post-Acute and Long-Term Care Medicine. The article covers everything the medical director needs to know about wound care...
The Effect of Oral Medication on Wound Healing
Given the accelerated medical discoveries of recent decades, there is a surprising lack of oral medications that directly improve wound healing. Of the oral medications available, most target ancillary aspects of wound care such as pain management, infection...
Skin Failure: An Emerging Concept
This article was recently published in the Journal of the American Medical Directors Association and is available for download. Skin failure is an emerging concept that ties together and clarifies current trends in clinical practice. Many studies have associated acute...
Pressure Ulcers In The Long-Term Care Setting: Clinical Practice Guideline Published By AMDA
Dr. Levine was on the advisory panel for revision of this guideline.This updated guideline is evidence based and incorporates the revised federal guidance to surveyors on pressure ulcers (Tag F314) including risk factors, infection, pain management, treatments based...
New Pressure Ulcer Chapter in the Geriatrics Review Syllabus
The Geriatrics Review Syllabus, 9th Edition, also known as GRS9, has been released and I am thrilled to be author of the newly revised and expanded chapter on Pressure Ulcers. The GRS9 is a comprehensive reference on geriatric medicine, a study guide for those...
Wound Healing in the Geriatric Patient
I recently served as invited guest editor of a special issue of Today's Wound Clinic on the aging wound care patient. My lead article is entitled Wound Healing in the Geriatric Patient. Other aging related topics in this issue include nutrition and wound care, and...