Guest Editorial: Perpetuating Information: The AAWC-OWM Partnership

     One of the most important contributions of the Association for the Advancement of Wound Care (AAWC) is the ability to increase the knowledge of our members, which ultimately leads to improved patient outcomes. As part of that goal, each year the AAWC looks to its leaders to provide insightful, provocative articles to Ostomy Wound Management that challenge, educate, and engage our members. As President of the AAWC, I am proud to present readers with this special AAWC issue.

     This year we have four original articles for OWM readers to analyze. The first is the result of the magnificent work performed by the AAWC Guidelines Subcommittee (AAWCGS). The AAWCGS created a follow-up project to their previously published content-validated venous ulcer guideline. This time the group focused on pressure ulcers. Faced with more than 20 currently available guidelines, consensus statements, and standards addressing the care of patients with pressure ulcers, clinicians can become confused and overwhelmed. Surprisingly, there is little agreement among these published tools regarding definitions, methodologies, and content-validation protocols. Considering pressure ulcer prevalence rates at 15% in US acute care facilities, $17 billion in treatment costs in 2003, an aging society, and recent regulatory changes (effective October 1 of this year) that link pressure ulcer incidence to decreased hospital payments, this project is very timely. Titled the “Pressure Ulcer Care Initiative” (PUCI), this “guideline of the guidelines” is being created through a process that involves dissecting each of the currently available publications into individual steps, applying a content-validation process for each step along the treatment course, and soliciting input from the wound care community to further enhance the reach, validation, and credibility of the process. I encourage everyone to read the document closely, participate in the process, and thank this volunteer team for their continued outstanding efforts to improve our evidence-based knowledge as we provide care to our patients.

     Dr. Jose-Contreras-Ruiz and his group provide us with an interesting case report and review of the literature on the topic of pyoderma gangrenosum. The case highlights the importance of taking a thorough history and the value of information gained from a wound biopsy. Individuals referred to a wound clinic are a subset of complicated patients from a much larger pool in the community. Due to this selection bias, wound clinicians need to be vigilant regarding unusual wound etiologies.

     Dr. Carrie Sussman provides an overview of available pain literature and describes how patients have local, systemic, and learned reactions (“pain memory”) in addition to acute reactions to painful stimuli. Recommendations are offered for clinicians to help anticipate and minimize patient discomfort.

     Dr. Mona Baharestani presents results of a nonrandomized, retrospective analysis of an Outcome and Assessment Information Set (OASIS) for home care patients treated with negative pressure wound therapy (NPWT) for Stage III or Stage IV pressure ulcers or surgical wounds. Early versus late initiation of NPWT may be associated with shorter length of stay, information that adds to our armamentarium of information on the use of NPWT.

     I hope you enjoy this AAWC issue of OWM and welcome your feedback. As always, we encourage your membership and participation in the AAWC.

This article was not subject to the OWM peer review process.