When the Skin Begins to Fail | Diane Krasner, Jeanine Maguire & Beatriz Coccaro Word | Healing By Design EP5

In Episode 5 of Healing By Design, hosts Jennifer Bierhup and Therese Laub are joined by wound care experts Diane Krasner, Jeanine Maguire, and Beatriz Coccaro-Word for an important conversation about skin failure, pressure injuries, and the need for greater clarity in how clinicians assess, diagnose, document, and communicate these conditions. The discussion explores one of the most challenging questions in wound care: when is skin breakdown truly a pressure injury, and when is the skin itself beginning to fail? Drawing from clinical experience, research, advocacy, and real patient cases, the group examines why clinicians must look beyond the wound itself and consider the whole patient. Perfusion, nutrition, mobility, chronic disease, organ failure, medications, and overall clinical decline can all change how a wound should be understood and treated. They also discuss the difference between skin failure and unavoidable pressure injuries, the importance of accurate provider documentation, conversations with patients and families, and PAWSIC's ongoing advocacy for dedicated ICD 10 codes for skin failure. At the center of the conversation is a shared goal: making sure the right diagnosis leads to the right care. **In this episode:** • Skin failure vs. pressure injury • Why clinicians need to assess the whole patient • Acute, chronic, and end stage skin failure • Avoidable and unavoidable pressure injuries • The role of perfusion, nutrition, organ failure, and comorbidities • Why provider diagnosis and documentation matter • Communicating skin failure with patients and families • The potential impact of dedicated ICD 10 codes • Education and implementation across the continuum of care • PAWSIC's ongoing advocacy for recognition of skin failure **WHITE PAPER AVAILABLE SEPTEMBER 15** This episode coincides with the release of PAWSIC's new position paper on skin failure, bringing together the evidence, clinical perspective, and rationale behind the need for greater recognition and dedicated coding of skin failure. The paper takes a deeper look at why accurate diagnosis matters, the implications across clinical, regulatory, and legal settings, and the work being done to move skin failure recognition forward. **Read the Skin Failure Position Paper beginning September 15:** https://pawsic.org/skin-failure-position-paper/read/ Healing By Design is a podcast powered by PAWSIC that explores the people, processes, and perspectives shaping better outcomes across the continuum of care.