Kennedy Terminal Ulcer

Lindsay Andronaco's picture

By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS

In the past two blogs I have discussed a controversial topic, skin failure. We all have strong feelings on this topic and have experienced different cases in our practice. Dispute the controversial feelings on KTUs and skin failure; I would like to now just address the viewpoint of the family and how to approach these difficult conversations.

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Lindsay Andronaco's picture

By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS

Part 2 in a series on skin failure
For Part 1, Click Here

In March of 1989 the National Pressure Ulcer Advisory Panel (NPUAP) convened, during which Karen Lou Kennedy first described the Kennedy Terminal Ulcer (KTU) phenomenon. A KTU is an unavoidable skin breakdown or skin failure that is thought to be a perfusion problem exacerbated by vascular/profusion insufficiency, organ failure, and/or the dying process. A KTU is a visible sign, an explanation, of what is transpiring within the patient.

Lindsay Andronaco's picture

By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS

Part 1 in a series on skin failure

A few years ago, a panel of experts gathered to evaluate the nature of skin changes at life's end (SCALE) and to discuss the Kennedy Terminal Ulcer (KTU). The panel concluded that there are observable changes in the skin at the end of life and that these situations are complex. It should be noted that the skin is an organ and it can fail. The skin can also demonstrate what is happening internally, such as multisystem organ failure.