Skin Failure: A Practical Concept when Properly Applied

Abstract

The concepts of skin failure and similar entities (e.g., Kennedy Terminal Ulcer) are not new to postacute and long-term care clinicians. 1 Schank J.E. Kennedy terminal ulcer: The “ah-ha!” moment and diagnosis. Ostomy Wound Manage. 2009; 55: 40-44 PubMed Google Scholar , 2 Man S.P. Au-Yeung T.W. Hypotension is a risk factor for new pressure ulcer occurrence in older patients after admission to an acute hospital. J Am Med Dir Assoc. 2013; 14: 627.e1-627.e5 Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar As Dr. Levine points out in this issue of the Journal, 3 Levine J.M. Skin failure: An emerging concept. J Am Med Dir Assoc. 2016; 17: 666-669 Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar we are seeing skin failure invoked more frequently these days, at least in narrative documentation, even though there is no current ICD-10 code that corresponds to it. This trend may reflect improved general recognition among practitioners of this type of skin breakdown, often widespread, as part of a multiple organ dysfunction syndrome, or it may reflect attempts to reduce liability by calling these ulcers something other than pressure ulcers. Probably both factors play a role in the increased use of this terminology. Skin Failure: An Emerging ConceptJournal of the American Medical Directors AssociationVol. 17Issue 7PreviewSkin failure is an emerging concept that clarifies trends in clinical practice. Its recognition provides common nomenclature, opens research directions, and questions assumptions regarding pressure ulcers as a quality measure. Adoption of the term is a step toward uniform terminology in compliance with a value based payment system. Full-Text PDF