From the Editor: Do Overs

Can we be 9 years old again for a moment? If you could have a do over — an interlude, a day, a decision you could change — what would it be? Would the decision involve regret (I wish I’d appreciated my grandparents more), a career choice (if I’d majored in Radio, Television, and Film at Temple University, maybe I now would be a lyricist for Disney), or an avoidable mishap (I never should have let our daughter keep an eye on the lamb chops when General Hospital was on)?

Part of the mission of Ostomy Wound Management is to provide the ammunition/information clinicians need to make knowledge-driven choices that ultimately avoid the need for do overs in providing care. In that regard, our journal supports the evidence-based approach to care currently championed in the practice of medicine. I confess, I do not understand why developing protocols founded on documented positive outcomes has suddenly become so important. Shouldn’t it always have been that way? Of note: I was similarly befuddled by all the hoopla of the nineties surrounding the multidisciplinary (now interdisciplinary) team approach. Shouldn’t practitioners always cooperate for the good of the patient?

The positive side of do overs is that humans tend to learn from their mistakes/failures and seek ways to improve what ails us. Research seems to commence at a post-error moment of insight with the realization that a new rationale/strategy/product is needed. We are eager to thwart negative outcomes, to right wrongs, to heal, to live. Often, this involves a great deal of trial-and-error — many do overs, if you will — especially in the provision of wound care where If-at-first-you-don’t-succeed thinking prevails. Once we discover what will help us achieve our treatment goal (an antimicrobial-infused dressing, an innovative surgical repair), it becomes our collective duty to share with other practitioners, especially those who, for example, insist gauze is the go-to product or that “this scar is the best it can look.” A new generation was able to enlighten its parents who insisted we butter burns or rub alcohol on feverish children. We must be similarly diligent in updating “seasoned” clinicians and teaching practitioners new to the fray.

This issue of OWM is a testament to eschewing do overs. Nutrition 411 seeks to heighten awareness of the effects of hyperbaric oxygen therapy on blood glucose. Pearls for Practice presents three cases in which hypochlorous acid was used with a hydroconductive dressing to help close previously unhealing traumatic battle injuries. Schwartz et al explore whether silver dressings remain a viable, comfortable option in forestalling surgical site infection, just as Kaiser et el compare the effect of common topical antimicrobials in vitro on drug-resistant and drug-sensitive strains of bacteria. Fujioka et al compare two types of flap surgery for the closure of sacral pressure ulcers (one clearly yielded better outcomes), and Chou et al show self-inflicted wound scars can be camouflaged using interchangeable skin grafts, allowing the patient to heal physically and emotionally and achieve the ultimate life do over.

Right now, despite missing my grandparents, writing songs only for family occasions, and fearful of ever leaving the kitchen with meat in the broiler, I seek no life do overs. I am in my seventeenth year of healthcare publishing, attending my fourteenth SAWC Spring, and (most proudly) Mom mom to five beyond spectacular grandchildren (three boys, two girls, all 4 years old and under). I wish you such fulfillment, triumph in all of your do overs big and small, and your continued reliance on OWM to inform all of your clinical and professional decisions.

Scars and Staph and amputation
Yucky photos. Granulation
Matrices that help wounds heal
Practice tips. The “audit” deal
Organizing wound care teams
Staging ulcers. Growing dreams
In this moment, be inspired!
Up and at ’em. Juices fired
Marvel at all you can do For your patients and for special you.

This article was not subject to the Ostomy Wound Management peer-review process.