From the Editor: The Power of Persistence

A good wound, ostomy, continence clinician is nothing if not persistent. In providing care for patients with long-evolving scenarios involving nonhealing wounds, fecal and/or urinary incontinence, and adjustments to and complications from ostomies, the clinician (often as part of a care team) must address numerous concerns that ebb and flow as part of the care process. Recurring problems require indefatigable ingenuity; research is continually emerging to inform and remind persons immersed in care of the new and novel as well as the tried and true (with evidence, of course). It is no wonder, then, that Ostomy Wound Management persists in revisiting pertinent issues such as pressure ulcer risk, wound-related pain, and the role of the ostomy nurse in home care.

Ahtiala et al¹ examined pressure ulcer risk assessment to determine the value of using the Sequential Organ Failure Assessment (SOFA) instrument as compared to the modified Jackson-Cubbin and Braden Scales in intensive care patients. Determining pressure ulcer risk has been the subject of no less than 10 recent OWM articles, several exploring the value of the Braden Scale in varied patient groups. The fact that awareness of the need for pressure ulcer risk assessment has exploded over the years is gratifying; this is no surprise, given the many known factors at play in the development of pressure concerns (eg, devices, immobility, age, comorbidities) and our goal to mediate them. Nor is the amount of research being conducted across care settings, ages, and countries. With pressure injury, what we don’t know can hurt us and our patients. The research shows knowledge of risk translates to prevention. Clinicians must remain persistent in their efforts to understand the risks and mitigate the factors that can be addressed. 

Like some pressure injuries, pain is often clinically and medically unavoidable but must be persistently considered and no longer can be dismissed as inevitable. In this era of opioid abuse, clinicians and researchers are seeking ways to manage or obliterate pain; thankfully, they are finding alternative methods of pain management. Rohilla et al² investigate a readily available, inexpensive approach to pain control during burn dressing changes: music. According to the Gate Control Theory of Pain developed by Melczak and Wall,³ sensory neurons (which can be stimulated by music) can override pain neurons. The persistence of clinicians who have studied music and similar alternative approaches to care has been rewarded with the recognition that not every clinical solution can be found in traditional (ie, medicine, “advanced” therapy) paradigms. OWM persists in publishing the work of authors who have studied the effects of alternative ways to manage treatment; subsequently, readers have benefitted from the journal’s open-minded diligence in presenting proven management methods, even when they come from the gentle thrum of a well-played sitar.

OWM also persists in publishing what might appear (after all these years of publication) to be the obvious but which cannot be overstated, such as the findings of the research conducted by Harputlu and Özsoy⁴ on the value of home care nursing in healing peristomal complications and its effect on quality of care. OWM articles have persistently underscored the importance of well-trained/educated ostomy clinicians in every relevant care setting, noting their impact on pre-, peri-, and postoperative care. The fact that studies continue to be conducted around the world implies that 1) the message remains new to certain populations and/or 2) research remains necessary to justify funding and personnel. 

Persistence has made OWM responsive to the changing needs of the industry. We request that our authors describe the literature they cite to ensure readers are immediately aware of the evidence levels on which conclusions and author statements are based (a quick review of other publications showed many articles require extra reader diligence in checking references). We persist in sticking with our double-blind, peer-review manuscript evaluation process, soliciting new members to our editorial board to keep our perspective fresh and exciting. We are redesigning our print journal and website, incorporating the results of reader opinions on what material is most desired/valuable. We have evolved from Ostomy Management (circa 1981) to Ostomy Wound Management (1985) to (tah-dah!) Wound Management & Prevention (coming January 2019), persisting in print and innovating online to inform this small but critically necessary health care niche. Unlike some publications, we are not going anywhere… but we hope professionally, you are, thanks to your persistence.  

The opinions and statements expressed herein are specific to the respective authors and not necessarily those of OWM or HMP. This article was not subject to the Ostomy Wound Management peer-review process.