Palliative Wound Care

Anthony Tickner, DPM FRCPS, FACCWS, FAPWH

In this interview, Dr. Anthony Tickner outlines the distinction between palliative and hospice care, as well as how clinicians can identify which framework is best for each, individual patient.

By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Pressure injuries (PIs) typically are the result of unrelieved pressure, shear, or force. In an inpatient or hospital setting, interventions are put into place to prevent pressure injuries based on evidence and patient risk. However, PIs still develop in some patients despite interventions. Experts agree that most PIs are in fact avoidable; however, some patients may experience unavoidable skin breakdown at end of life (EoL).¹ Kennedy terminal ulcers (KTUs), skin changes at life’s end (SCALE), and Trombley-Brennan terminal tissue injuries (TB-TTIs) are some of the common terms used to describe unavoidable skin changes at EoL.¹

By: Mary Brennan, RN, MBA, CWON, Karen Lou Kennedy-Evans, RN, FNP, APRN-BC, and Diane Krasner, PhD, RN, CWCN, CWS, MAPWCA, FAAN

What is the best way to differentiate between a Trombley-Brennan terminal tissue injury (TB-TTI) and deep tissue injury (DTI)?

Mary: This is the most challenging because these injuries resemble one another. The difference is that a TB-TTI does not evolve as a DTI does. There may be an increase in surface area but no change in the appearance or type of tissue. A TB-TTI will look the same in color and appearance on day 3 or 5 as it does on day 1.

Article Title: Pressure Injury Progression and Factors Associated With Different End-Points in a Home Palliative Care Setting: A Retrospective Chart Review Study
Authors: Artico M, D’Angelo D, Piredda M, et al
Journal: J Pain Symptom Manage 2018;56(1):23-31
Reviewed by: Arden Harada, class of 2021, Temple University School of Podiatric Medicine

by the WoundSource Editors

Palliative care and hospice care are not the same, but they both share one goal. They both focus on a patient's physical, mental, social, and spiritual needs. Palliative care can begin at diagnosis and treatment or for patients at any stage of their illness. Patients may not want to receive aggressive treatment of non-healing wounds because of underlying diseases, pain, and/or cost.

by Holly Hovan MSN, APRN-ACNS-BC, CWOCN-AP

By Aletha Tippett MD

I have written about so many things over the past years… Maybe now is a good time to announce that I am writing a book called Hear Our Cry, an autobiographical story about 20 years of wound care and limb salvage. The process has had quite an impact on me, reviewing all the pictures and notes from my wound patients from the past two decades.

By Mary Ellen Posthauer RDN, CD, LD, FAND

Recently there have been numerous articles and webinars focusing on the methods health care professional can employ to effectively communicate and engage in end of life conversations with patients receiving palliative and/or hospice care.

By Aletha Tippett MD

There is lots in store for the new year, and a great many wound care conferences just chock-full of information. There is one conference this year that you may not know about—small, quiet, highly informative and productive. That is the 2015 Palliative Wound Care Conference that will be held in Orlando, Florida, in May this year.

By Aletha Tippett MD

The topic of grief and bereavement is near to my heart right now as I just lost my beloved therapy dog, Barney, suddenly to hemangiosarcoma after years of service. He was an important and valued part of our healing community and will be mourned for a long time.