Many in the wound care community use the term skin failure to suggest a cause for the development of a pressure ulcer. I respectfully challenge the term in that context.
In the May 2012 issue of Ostomy Wound Management,1 the authors of “A Prospective, Descriptive Study of Characteristics Associated With Skin Failure in Critically Ill Adults” stated, “Critically ill patients with multi-organ failure are especially susceptible to problems with skin integrity, including skin failure. These patients frequently have alterations in tissue perfusion and, because of their failed organs, are unable to maintain homeostasis. This may lead to the death of the skin and underlying structures.” The key terms here are susceptible and tissue perfusion. I agree skin is susceptible to pressure ulcers, but in this context, skin rarely dies without pressure. This article defines skin failure as “an event in which skin and underlying tissues die due to hypoperfusion concurrent with critical illness.” I challenge this definition by asking, Where does the skin die? A similar question may be asked regarding the Kennedy Terminal Ulcer.2 In true skin failure, it would be reasonable to expect to see dying skin over any part of the body. However, in most of the literature, when the term skin failure is used in relation to pressure ulcers, almost all of the “skin failures” are over pressure points.... continue reading about Guest Editorial: “Skin Failure” as a Cause of Pressure Ulcers: Accurate Terminology, Misnomer, or Cop Out?