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Journal of Community Nursing (JCN) | October 2021

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Are pressure injuries unavoidable at the end of life?

Are pressure injuries unavoidable at the end of life?
Pressure ulcer prevention

Pages: 36 - 41

Article topics: End of Life, End of Life Care, Kennedy Report, Palliative and end of life care, Pressure injury, Pressure Ulcer, pressure ulcer healing, Pressure ulceration, Skin changes

Pressure injuries are sometimes considered to be due to a lack of good nursing care. However, it has been debated as to whether the development of some pressure injuries at the end of life is inevitable. More recently, the term ‘skin failure’, which occurs in dying patients, has been introduced in the wound care literature, and it is proposed that the presence of skin failure may make pressure injury inevitable. This article defines the theories around skin failure and presents the different terminologies used to describe skin damage typically found in the dying patient, such as the Kennedy ulcer and Trombley- Brennan terminal tissue injury (TB-TTI). It also discusses the importance of healthcare professionals being able to recognise that skin changes, which appear to be pressure injuries, are due to skin failure at the end of life and be able to differentiate between these and usual pressure injuries when planning and delivering care for these patients.

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