Jeffrey M. Levine MD | Geriatric Specialist | Wound Care | Pressure Ulcers - News on Dr. Levine's medical and consulting practice, and reflections on our healthcare system.

Category: Featured

Skin Failure: An Emerging Concept

This post is based on my article that recently appeared in the Journal of the American Medical Directors Association. Skin failure is an emerging concept that ties together current trends in clinical practice and deserves wider acceptance. Wound care providers have long recognized that skin failure exists, but adoption of the name has been limited due to confusion as to its clinical manifestations. Terms such as Kennedy …Read More

New Pressure Ulcer Chapter in the Geriatrics Review Syllabus

The Geriatrics Review Syllabus, 9th Edition, also known as GRS9, has been released and I am thrilled to be author of the newly revised and expanded chapter on Pressure Ulcers.  The GRS9 is a comprehensive reference on geriatric medicine, a study guide for those preparing to take board examinations, and a teaching resource for residents, students, and other trainees.  GRS9 is updated every three years, …Read More

Pressure Ulcers are an Under-Appreciated Public Health Issue

As a geriatric fellow back in the 1980’s I became intrigued by the wide prevalence of pressure ulcers and how little literature there was on this disease.  Three decades later, they have not gone away and it amazes me that they are not on the list of recognized public health threats.   According to the Agency for Healthcare Quality and Research, pressure ulcers affect up …Read More

Recognizing the Incurable in Ancient Egypt

The art of medicine is as old as human civilization, and what we think is new has often been done before. When researching the history of wound care I came across an interesting historical antecedent to today’s palliative care practices. I found it in the library of the New York Academy of Medicine in Manhattan, in a translation of an ancient Egyptian medical scroll, the …Read More

Infections Related to Pressure Ulcers are Always Serious

Infections related to pressure ulcers are always serious events because most patients with these wounds are already compromised, and open wounds provide a portal for pathogenic bacteria to enter the body. Reasons for compromise include immobility, neurologic impairment and acute or chronic organ system disease. Begin with a compromised patient, then add an infected pressure ulcer, and you have a serious medical situation that requires immediate attention. Factors that favor …Read More

The Geriatric Workforce and Quality of Care

What could be less intuitive than a shrinking medical specialty in the face of surging demand? A recent New York Times article discussed the growing shortage of geriatricians in America. Despite the fact that there are more older Americans than any time in history, there are only about 7,000 geriatricians in practice in the United States. The article points out that the field is becoming even …Read More

Body Casts in WWII: A Historical Perspective on Medical Device Related Pressure Ulcers

Surgeons and medics apply a plaster-of-paris body cast on an injured soldier.  Photo courtesy of the New York Public Library.  During WWII, the incidence of pressure ulcers in young injured soldiers increased as a result of plaster body casts and immobilization splints – an early example of medical device related pressure ulceration.  Plaster-of-paris has been used for centuries to treat fractures by immobilizing bones and allowing undisturbed …Read More

Historical Roots of the “Avoidable-Unavoidable” Pressure Ulcer Controversy

This post gives another preview of what I will be covering in my upcoming webinar entitled History of Pressure Ulcers & Wound Care: Past, Present, & Future, sponsored by the National Pressure Ulcer Advisory Panel.  Some years ago while browsing in an antiquarian bookstore I opened a volume entitled Lectures on the Diseases of the Central Nervous System by Jean Martin Charcot published in 1877. Among …Read More

Upcoming Webinar on History of Pressure Ulcers & Wound Care

I am thrilled to announce that registration is now open for my webinar entitled History of Pressure Ulcers and Wound Care: Past, Present and Future, sponsored by the National Pressure Ulcer Advisory Panel (NPUAP). This event takes place on November 19th at 1:00 PM EST, and coincides with World Wide Pressure Ulcer Prevention Day 2015. My discussion covers such topics as wound care in Ancient …Read More

Government Data Sheds Doubt Upon Pressure Ulcers as a Quality Indicator

Nearly all organizations concerned with healthcare quality have recognized pressure ulcers as a quality indicator. This assumption has impacted reimbursement policy and facility ratings, and resulted a risk-management burden for caregivers across the healthcare continuum. Despite the fact that pressure ulcers can sometimes reflect upon quality of care, it is increasingly recognized that many pressure ulcers are unavoidable. A new analysis of data collected by the Office of …Read More