Despite increasing acceptance of skin failure, more understanding is needed to address risk factors and advance more rigorous analysis, according to researchers.
Kennedy terminal ulcers are more widely recognized in long-term care than ever before, but they are only one of several skin failure types, noted nursing professors at Queensland University of Technology in Australia who reviewed three previous studies of the phenomena.
Acute skin failure occurs along with a critical illness, such as septic shock, while chronic skin failure may be a symptom of a chronic disease, like dementia. A Kennedy ulcer is a type of pressure injury associated with end-of-life failure. Skin failure also can present as gangrenous fingers or toes, blisters or skin mottling away from pressure points.
One study identified risk factors for acute skin failure, while another found that simply being in the ICU increased pressure injury risk. But the acute failure terms were applied differently in each study and according to different standards.
“The multitude of interrelated terms and concepts used throughout the literature … has resulted in linguistic and conceptual confusion,” the Australian team wrote, calling for additional research into etiology and pathophysiology. “This will ensure a solid theoretical and biologic foundation for defining the term and lead to practice improvement.”
