Jeffrey M. Levine MD
Geriatrics • Internal Medicine • Wound Care
Dr. Levine is a nationally recognized expert in wound care and pressure injuries. He is a faculty member of the Department of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mount Sinai and has an active wound care practice in a long-term care facility. He is an alumnus of the National Pressure Injury Advisory Panel (NPIAP) and author of numerous publications including the chapter on Pressure Injuries and Wound Care in the Geriatric Review Syllabus published by the American Geriatrics Society (AGS).
My article on medical device related pressure injury (MDRPRI) of the ear appears in the June issue of Advances in Skin and Wound Care. In it you will read about CMS requirements for masking in long-term care, as well as prevention, documentation, and treatment of pressure injury to the ear. Access the article here.
In the course of my research on the fascinating history of wound care, I found a case report from 1945 in the British Medical Journal of a novel pressure injury treatment employed by German doctors in World War II. Research on the the article took two years, and included finding and interviewing the descendants of the author. Access the article here.
I had the privelige of authoring the 9th, 10th, and 11th Editions of the Pressure Injuries and Wound Care section of the Geriatrics Review Syllabus: A Core Curriculum in Geriatric Medicine. This is a comprehensive reference and the primary source for physicians preparing to take board examinations. Read more about the GRS here.
These are recommendations that physicians offered for avoiding the Black Death that ravaged Europe in the 14th Century, as related from the book entitled Hecker’s Epidemics of the Middle Ages.
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.
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.