Closing the Gap of Health Disparity in the Wound Care Industry With the Use Long Wave Infrared Thermography in Dark Skin Individuals Editorial Summary In healthcare, skin color presents its own set of challenges where inequity is evident. Studies have indicated that black and brown people are twice as likely to die from diabetes than white people,3 black and brown people account for 12.1% of people with diabetes, compared to 7.4% of non-hispanic white people,4 darker pigment skin have a higher occurrence of pressure injuries (PI) 5,6,75.5% of black men and 75.7% of black women developed hypertension by the age of 55 compared to 54.5% of white men and 40% of white women,7 and blacks had 1.5 to 2 times higher risk of hypertension.7 This article outlines how these issues can be addressed.
Introduction
H
ealth disparity in the United States has been defined as differences that exist among specific population groups in the attainment of full health potential that can be measured by differences in incidence, prevalence, mortality, burden of disease, and other adverse health conditions.1 These disparities can negatively impact outcomes on a specific group of people creating a downward spiral in their health, their quality of life and burden the health system affecting future generations.
In healthcare, skin color presents its own set of challenges where inequity is evident. Studies have indicated that black and brown people are twice as likely to die from diabetes than white people,3 black and brown people account for 12.1% of people with diabetes, compared to 7.4% of non-hispanic white people,4 darker pigment skin have a higher occurrence of pressure injuries (PI),5,6 75.5% of black men and 75.7% of black women developed hypertension by the age of 55 compared to 54.5% of white men and 40% of white women,7 and blacks had 1.5 to 2 times higher risk of hypertension.7
Mr Frank Aviles Wound Care Clinical Coordinator, Natchitoches Regional Medical Center Natchitoches LA, United States
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In the wound care field, especially in the outpatient clinics, our chronic wounds are typically stuck in the inflammatory phase and our aim is to progress them along the healing cascade. While in the inpatient settings, patients are at risk of developing pressure injuries, admitted for management of a diabetic foot ulcer infection, and surgical site infections or dehiscence. The common denominator in both settings is the fact that the
Wound Masterclass - Vol 1 - Month 2022
wound/ periwound tissue may be in the proverbial prolonged inflammatory stage. Skin has been an indicator of our health. As healthcare workers, we assess each individual patient’s skin to unfold the untold story. Do they have scars to determine history of prior wounds and/ or surgeries, any healed or unhealed areas over bony prominences, visual and tactile changes assessing signs of inflammatory abnormalities, eliciting a blanchable response, presence of callouses, and diabetic foot ulcer complications. These signs can be helpful in preventative and treatment programs. A key successful element to any pressure injury prevention program is a skin assessment. The National Pressure Injury Advisory Panel (NPIAP) recommends that an assessment should include noting localized heat, edema or induration. The visual skin assessment may be easier to observe on a light pigmented individual, but it becomes a challenge and a disadvantage on darker pigmented skin. Baumgarten et al.8 and then Rosen et al.9 found darker pigmented residents were more likely to have a grade 2 - 4 ulcers than lighter counterparts suggesting failure to identify early signs based on skin pigmentation. In 1995, the National Pressure Ulcer Advisory Panel (NPUAP. Currently known as the National Pressure Injury Advisory Panel – NPIAP) developed a task force to determine the best method to detect early signs of pressure damage on dark pigmented skin.10,11
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