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.
Wound Odor: The View from Ancient Greece
The fascinating history of wound care dates back to the earliest human cultures, where prehistoric bones and cave paintings left hints of wound-healing knowledge. A major problem associated with wounds is odor, a phenomenon recognized for millennia. In today’s...
Speaking of Aging Skin at NPIAP
I am pleased to announce that I will be speaking at the upcoming National Pressure Injury Advisory Panel Annual Conference on the topic of aging skin. The NPIAP’s core mission is to provide interprofessional leadership to improve patient outcomes in pressure injury prevention and management through education, public policy, and research.
Is There a COVID-Related Wound?
This blog post explores whether there is a link between COVID and wounds. Understanding of this disease is still in the early stages, and it is unclear whether these skin lesions are the result of comorbidities or coinfection with other agents, or whether COVID-19 is actually responsible. The following skin lesions have been described with COVID-19 infection:
Suspension Therapy for Pressure Injuries: A Rediscovered Footnote to Nazi Medicine
Shortly after German surrender in WWII, a medical officer from occupying British forces inspected a military hospital in Germany and described a treatment for pressure injuries developed by Nazi doctors. The treatment, based on suspension of the patient by wires drilled into pelvic bones, has been lost to history until now.
History of Pressure Injury Treatment at the New York Academy of Medicine
I was recently honored to present at the New York Academy of Medicine’s 11th Annual History of Medicine Night, along with five other distinguished lecturers. My topic was entitled Bed-Sore Treatment by Suspension: A Case Report from WWII. While perusing old journals...
Skin Failure, Unavoidable Pressure Injuries, and Terminal Ulceration at NPIAP
I recently presented on the topic of skin failure at the National Pressure Injury Advisory Panel (NPIAP) annual meeting in Houston on February 27th and 28th, sharing the podium with Janet Cuddigan PhD, RN, FAAN, President of NPIAP. The goal of our session was to...
Skin Failure at WoundCon 2020
This past winter I presented on SKIN FAILURE at WoundCon, the first of its kind ONLINE Virtual Wound Care Conference and Expo. Brought to you by the publishers of WoundSource®, this full-day virtual conference on Thursday, April 2, 2020 included a series of CME/CE...
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...
Pressure Injuries Expanded by CMS as Indicators of Hospital Harm
CMS has implemented a new quality measure for hospitals that expands the array of pressure injuries considered as adversely impacting quality care. The new measure, developed in a program to provide electronic clinical quality measures (eCQMs), widens the scope of...
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...