Terminal Ulcer Terminology Reconsidered
My new article in Wound Management & Prevention is a critical re-examination of terminal ulcer terminology. In it I make the case for recognizing terminal ulcers as part of the spectrum of skin failure (and not necessarily heralding death) and used only in situations where patients are recognized as actively dying.
The article presents several reasons why terminal ulcer terminology should be used only in limited fashion. These include the conflation of diagnosis and prognosis which are separate concepts, inaccuracy of prediction of death, advances in healthcare technology, variation in end-of-life trajectories, and introduction of defensive verbiage that relies on the impending death to relieve caregivers of responsibility for potential quality deficit.
Finally I argue that terminal ulceration needs to be recognized as part of the spectrum of skin failure, drawing on physiology to explain both acute breakdown and impaired wound healing in many patients.
Access my article in Wound Management & Prevention (formerly Ostomy Wound Management) HERE.
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Related links:
Pressure Injuries and the Human Warranty
Wound Care in the Geriatrics Review Syllabus
Wound Care: What the Medical Director Needs to Know
Determining the Avoidability of Pressure Ulcers
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Source: Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - Category: Geriatrics Authors: Jeffrey Levine Tags: An Aging World Featured Medical Articles Geriatric Medicine Pressure Injuries & Wound Care Publications Risk Management bedsores decubiti decubitus ulcer end-of-life care geriatrics Healthcare Quality Jeff Levine MD Jeffrey M Lev Source Type: blogs
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