The phenomenon of skin failure as distinct from pressure ulcers has been documented in the adult literature. However, in the pediatric population, skin injury continues to be grouped indiscriminately as various types of pressure ulcers.To identify and describe the phenomenon of skin failure in critically ill children.Retrospective chart review of 19 patients who had serious skin injuries develop. Organ dysfunction scores, medications, pressure ulcer prevention techniques used, and laboratory values in the 7 days leading up to the development of a skin lesion were evaluated.At the start of the evaluation period, all patients (N = 19) had pressure ulcer prevention measures in place before the development of a serious skin injury. All of the skin lesions were full-thickness injuries on the day they were identified (as opposed to the more gradual progression from simple to complex skin injuries typically seen in pressure ulcers). As predicted, 18 of 19 patients had multiple organ dysfunction syndrome (MODS) in the week leading up to the skin injury. All patients with MODS had at least 2 dysfunctional systems, and 12 patients had 4 or more dysfunctional systems. Of the 19 patients, 8 (42%) progressed to death, compared with 1.8% in our general pediatric intensive care unit population.Although the traditional paradigm is that pressure ulcers are preventable, a subset of pressure ulcers in critically ill children may actually represent acute skin failure as a consequence of MODS.

Katie E. Cohen

Matthew C. Scanlon

Amin Bemanian

Christine A. Schindler

American Journal of Critical Care

美国重症监护杂志 (AJCC) 的编辑邀请作者提交原始手稿，描述与重症和急性病患者护理相关的所有专业的调查、进展或观察。鼓励合作实践和研究的论文。稿件将被考虑，但前提是它们尚未在其他地方发表并且仅提交给 AJCC。

The editorial team of the American Journal of Critical Care invites authors to submit original manuscripts that describe investigations, advancements, or observations related to the care of critically ill and acutely ill patients. We encourage papers that promote collaborative practice and research. Manuscripts will be considered only if they have not been published elsewhere and are submitted exclusively to this journal.

美国重症监护杂志 (American Journal of Critical Care) 编辑诚邀作者提交原创手稿，内容涉及重症和急性病患者护理相关的各类研究、进展或观察。我们鼓励提交合作实践和研究的论文。所有稿件必须为未在其他地方发表且仅提交给本杂志。

Pediatric Skin Failure

A subset of pressure ulcers in critically ill children may actually represent acute skin failure as a consequence of MODS, and the traditional paradigm is that pressure ulcer prevention measures are preventable.

Category	Quartile
医学	3
医学, 护理	3
医学, 危重病医学	4

Pediatric Skin Failure

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