My new article entitled Pressure Injuries and Skin Failure: The Search for Clarity, published in the February 2026 issue of International Wound Journal (IWJ) provides a historical review of skin failure, beginning with the works of Jean Martin Charcot and Florence Nightingale and moving to a plan for the future. Key points of this article include:
• The proliferation of overlapping terms and definitions for skin failure has produced conceptual confusion that undermines clinical assessment, documentation, quality measurement, and regulatory consistency across healthcare settings.
• Pressure injuries and skin failure are often framed as separate entities, but clinical and physiologic evidence supports a unified pathophysiologic spectrum rather than discrete or mutually exclusive diagnoses.
• Skin failure arises from the interaction of mechanical tissue deformation with systemic physiologic vulnerability—including hypoperfusion, inflammation, vascular dysfunction, multimorbidity, and diminished physiologic reserve related to malnutrition, aging, pharmacologic factors, and chronic disease.
• A unified, interdisciplinary definition of skin failure applicable across the healthcare continuum is urgently needed to support accurate diagnosis, fair quality assessment, and the development of predictive models that integrate physiologic data with advanced analytics.
Access this article HERE.
Download my article: Skin Failure Concept Review and Proposed Model
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Jean Martin Charcot’s Lecture on Pressure Ulcers: An Important Historical Document
Recognizing the Incurable in Ancient Egypt
Body Casts in WWII: A Historical Perspective on Medical Device Related Pressure Ulcers