Kennedy Terminal Ulcers

Abstract

Kennedy terminal ulcers, a subset of pressure injuries, are associated with the dying process. This scoping review aimed to identify and map the published literature on Kennedy terminal ulcers in terms of its definition, prevalence, assessment, treatment, management, health care costs, and quality of life for patients in all health care settings. Using the Arksey and O'Malley scoping review framework, we systematically searched the Cochrane Library, CINAHL, EMBASE, MEDLINE, and ProQuest databases and 5 guideline repositories between 1983 and 2018. The following search terms were used: Kennedy ulcers, Kennedy terminal ulcers, terminal ulcer, skin failure, and Skin Changes at Life's End. Data were extracted using a purposely developed data collection tool. Initial searches yielded 2997 sources, with 32 included in this review. Most Kennedy terminal ulcer literature was published by nurses in the United States. Kennedy terminal ulcer prevalence data are limited, with no validated assessment tools available. Kennedy terminal ulcers may be misclassified as pressure injuries, potentially resulting in financial penalties to the institution. This scoping review revealed significant knowledge and clinical practice gaps in patient assessment, management, and treatment of Kennedy terminal ulcers. Timely patient education may help them to make informed care and quality end-of-life decisions. Further research is needed to inform clinical practice to improve patient care.

Diagnóstico de enfermagem síndrome de terminalidade em idosos com demência avançada: mapeamento cruzado

“…A Dor crônica esteve presente em 44,7%, o que se aproxima do estimado pela OMS de 47% para pacientes em cuidados ao fim de vida com demência 2 . Houve ainda alta frequência de Integridade tissular prejudicada e a Integridade da pele prejudicada (73,3%) esperadas por associarem-se as condições nutricionais, idade avançada, incontinência, fragilidade capilar, baixa imunidade e mobilidade [19][20][21][22] . Além disso, as lesões em pacientes idosos com demência avançada são indicadores de cuidados ao fim de vida 23 .…”

Medical referral criteria for palliative care in adults: a scoping review

“…These general factors (Table 1) are extended to the numerous disease specific factors presented in Table 2. In the literature, access to PC is not constricted to strictly defined primary causes of deaths, but is enumerated with regard to all major ones due to chronic diseases [8], [12][13][14][15][16][17][18][19][20][21]. Cancer, as a leading group of diseases referred to PC, is definitely not a homogenous group of disorders.…”

Skin injuries associated with severe life‐threatening situations: A new conceptual framework

“…These lesions start as small abrasions with darkened areas and progress very quickly into the deep tissues, sometimes within a few hours. They are pear-, butterfly-, or horseshoe-shaped (usually symmetrical or mirror-like), with changes in turgor and colour (predominantly red, yellow, or black as they progress), and are often painful (Ayello et al, 2019;Latimer et al, 2019;Sibbald & Ayello, 2020).…”

“…The author defined it as a variant of PIs matching Charcot's description of "decubitus ominosus" more than 100 years earlier (Charcot, 1881). However, this classification as a variant of PIs has been challenged by a number of authors (Latimer et al, 2019;Yastrub, 2010).…”