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 and chronic skin ulceration with mortality, yet the term skin failure has not been adapted to this phenomenon. Wound care providers have long recognized that skin failure exists, but common use of the term has been limited due to confusion as to its clinical manifestations. Terms such as Kennedy Terminal Ulcer (KTU), skin changes at life’s end (SCALE), and the Trombley-Brennan Terminal Tissue Injury (TB-TTI) lesion have been advocated to describe the common clinical observation of skin breakdown in patients who are dying.4e6 However this nomenclature does not fit into the clinical course of wounds that have similar characteristics but the patient does not expire. The term skin failure assembles these clinical observations into an easily understandable and more clinically accurate term.
The complete reference is Levine JM. Skin Failure: An Emerging Concept. J Am Dir Assoc July 1, 2016 Volume 17, Issue 7, Pages 666–669