With medical advancements in past decades, patients frequently survive acute and/or chronic conditions that once relegated them to immediate death. Consequently, medical conditions, such as integument failure, once without time to manifest, are now commonly observed. In 2014, the Centers for Medicare and Medicaid Services (CMS) set a goal to reduce the number of hospital-acquired conditions (including pressure injuries) by 20%. The most recent Agency for Healthcare Research and Quality report indicates that, while the number of hospital-acquired cases was improved from 2014 to 2016, conditions such as pressure injuries can and should be further reduced.
Because of the complexity of the underlying mechanism leading to integument failure, it is imperative not only to better understand its underlying pathophysiology but also to accurately classify integument injury by the avoidable and unavoidable factors responsible for injury, including pressure. In a study published in Medscape, the authors’ opinion is that available scientific evidence indicates integument failure is multifactorial and due to comorbid factors, that can reduce angiosome perfusion. The diagnosis of skin breakdown as a “pressure injury” should be a diagnosis of exclusion rather than an automatic conclusion, despite the high likelihood of being the actual diagnosis.
Skin failure is a relatively new diagnosis and we need to remember that skin is an organ and organs, like any other organ in the body, can fail. This is an interesting study and one that could assist us, as caregivers, in identifying types of wounds with the goal of implementing treatment modalities to effectively prevent and/or treat wounds. Take a few minutes to read this article, it is a good read and worth the time! Stay the course, stay well, get vaccinated, mask up and stay tuned!