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A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute

It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male pa...

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Autores principales: Kim, Jung Hwan, Shin, Hea Kyeong, Jung, Gyu Yong, Lee, Dong Lark
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Plastic and Reconstructive Surgeons 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369049/
https://www.ncbi.nlm.nih.gov/pubmed/30685945
http://dx.doi.org/10.5999/aps.2018.00087
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author Kim, Jung Hwan
Shin, Hea Kyeong
Jung, Gyu Yong
Lee, Dong Lark
author_facet Kim, Jung Hwan
Shin, Hea Kyeong
Jung, Gyu Yong
Lee, Dong Lark
author_sort Kim, Jung Hwan
collection PubMed
description It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male patient was admitted to our intensive care unit with sepsis due to bacterial pneumonia. Despite the use of air cushions and regular position changes, skin ulcerations occurred over his occiput, back, buttock, elbow, and ankle. After improvement in his general condition, he was transferred to the department of plastic and reconstructive surgery. Debridement was performed immediately, followed by conservative treatment (including a vacuum-assisted closure device) for 6 weeks. The buttock and occiput wounds were treated surgically. Despite complete healing, his caregivers sued the hospital for failing to prevent PU formation. ASF is a pressure-related injury resulting from hemodynamic instability due to organ system failure. Unlike PU, ASF may occur despite the implementation of all appropriate preventive measures. Furthermore, misdiagnosis of ASF as PU can lead to litigation. Therefore, it is critical for the proper diagnosis to be made quickly, and for physicians to explain that ASF occurs despite proper preventative treatment.
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spelling pubmed-63690492019-03-01 A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute Kim, Jung Hwan Shin, Hea Kyeong Jung, Gyu Yong Lee, Dong Lark Arch Plast Surg Case Report It is difficult to differentiate acute skin failure (ASF) from pressure ulcer (PU). ASF is defined as unavoidable injury resulting from hypoperfusion caused by severe dysfunction of another organ system. We describe a case of ASF mistaken as PU that resulted in a legal dispute. A 74-year-old male patient was admitted to our intensive care unit with sepsis due to bacterial pneumonia. Despite the use of air cushions and regular position changes, skin ulcerations occurred over his occiput, back, buttock, elbow, and ankle. After improvement in his general condition, he was transferred to the department of plastic and reconstructive surgery. Debridement was performed immediately, followed by conservative treatment (including a vacuum-assisted closure device) for 6 weeks. The buttock and occiput wounds were treated surgically. Despite complete healing, his caregivers sued the hospital for failing to prevent PU formation. ASF is a pressure-related injury resulting from hemodynamic instability due to organ system failure. Unlike PU, ASF may occur despite the implementation of all appropriate preventive measures. Furthermore, misdiagnosis of ASF as PU can lead to litigation. Therefore, it is critical for the proper diagnosis to be made quickly, and for physicians to explain that ASF occurs despite proper preventative treatment. Korean Society of Plastic and Reconstructive Surgeons 2019-01 2019-01-15 /pmc/articles/PMC6369049/ /pubmed/30685945 http://dx.doi.org/10.5999/aps.2018.00087 Text en Copyright © 2019 The Korean Society of Plastic and Reconstructive Surgeons This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Kim, Jung Hwan
Shin, Hea Kyeong
Jung, Gyu Yong
Lee, Dong Lark
A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute
title A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute
title_full A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute
title_fullStr A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute
title_full_unstemmed A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute
title_short A case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute
title_sort case of acute skin failure misdiagnosed as a pressure ulcer, leading to a legal dispute
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6369049/
https://www.ncbi.nlm.nih.gov/pubmed/30685945
http://dx.doi.org/10.5999/aps.2018.00087
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