Bain M, Hara J, Carter MJ, et al.
Wounds : a compendium of clinical research and practice. Date of publication 2020 Nov 1;volume 32(11):319-327.
1. Wounds. 2020 Nov;32(11):319-327.
The Pathophysiology of Skin Failure vs. Pressure Injury: Conditions That Cause
Integument Destruction and Their Associated Implications.
Bain M(1), Hara J(1), Carter MJ(2).
Author information:
(1)Hoag Memorial Hospital Presbyterian, Newport Beach, CA.
(2)Strategic Solutions, Inc., Bozeman, MT.
INTRODUCTION: Although integument failure commonly is attributed to pressure
alone, especially when a wound develops over a bony prominence (pressure injury),
all skin failure should not be attributed to pressure injuries.
OBJECTIVE: A systematic review of the literature was conducted to: (1)
differentiate the types of integument injury and etiology; (2) describe the
anatomic and pathophysiologic factors affecting integument failure; (3)
differentiate avoidable vs. unavoidable integumentary injury of
nonpressure-related sources; (4) describe factors leading to integument injury,
including comorbid and risk factors; and (5) briefly discuss clinical and
economic importance of delineating pressure injuries from integument failure and
associated risk factors in order to determine the pathophysiology underlying
wound development and multiple factors capable of interacting with pressure to
synergistically influence integumentary failure.
METHODS: The PubMed database was searched for English-language studies during
March 2020 using the key words pathophysiology, etiology, pressure ulcers,
pressure injury, pressure wounds, and risk factors.
RESULTS: The PubMed search yielded 1561 publications in total; of these, 59 were
selected for review based on their relevance, timeliness, and subject matter,
including 50 original studies of any study design, 5 review articles, and 4
public agency reports that addressed the 5 study purpose components.
CONCLUSIONS: Clinicians need to better understand the pathophysiology and
classification of integument injuries by underlying etiologies both avoidable and
unavoidable. A more accurate diagnosis would lead to more appropriate treatment
strategies, an improved quality of care for affected patients, less wasted
resources and reduced financial penalties for healthcare providers, and decreased
medicolegal claims.
PMID: 33465042 [Indexed for MEDLINE]
