From the Editor: The Advantages of April
April, T.S. Eliot wrote, "is the cruellest month, breeding/ Lilacs out of the dead land, mixing/ Memory out of desire, stirring/ Dull roots with spring rain." Emerson, not to be outdone, chimed in, "April cold with dripping rain...." And even though we are taught, "April showers bring May flowers," one has to endure all the umbrella weather before the lilacs appear. Oh, and I won't even mention the demons of April 15th.
Ah, but April has its benefits. Clocks (in most areas of the US) are sprung ahead 1 hour to capture as much daylight and warmth as possible. Baseball recommences. Two significant Judeo-Christian holidays (Passover and Easter) frequently fall within the month, as do several other holidays of various cultures and countries. We sing of April love ("It's for the very young"). Every day in April marks the anniversary of some important event - from April 1st and the birth (in 1578) of William Harvey, the physician who discovered the circulation of blood, to April 30th and the purchase of the Louisiana Territory in 1803 (not to mention the first public broadcast of television on that date in 1939).
Wounds, like April, often appear to go from bad to what seems to be worse before things start to improve. Teasing and hopeful as Spring days (but we're no April fools!), the initial progression of what appears to be a healing wound stalls, leaving clinician and patient to contemplate other systemic and local options and their ramifications. Thankfully, rarely do wound clinicians - or their patients, for that matter - become complacent. Rather, they are aggressive in their desire to, at the very least, improve the quality of life of the patient with the chronic wound, and ideally, heal the wound.
Recently, a crucial - and largely ignored - component of wound care came to the forefront. Pain. For ages, everyone acknowledged wounds hurt, but pain was an accepted part of the wound sequelae. With the publication of the European Wound Management Association Position Document, which focused on pain at dressing changes, came further validation that pain associated with wound care should not be assumed or dismissed as inevitable. Ostomy/Wound Management, in anticipation of clinician demand for increasing amounts of information on pain as it becomes available, initiated "Addressing the Pain," which this month features the study that kick-started recognition of the need to treat pain as we would treat any other aspect of wounds. Also in this issue, the sterile-versus-nonsterile technique debate is revisited, as is the use of hyaluronic acid - in this case, a novel ester of hyaluronic acid. The potential of pharmacotherapy as adjunctive therapy and the likelihood for epidermoid cancers to masquerade as venous ulcers additionally are discussed.
As we all must do in April (ie, try to see past the gloomy days to the brighter days ahead), clinicians use what they read in OWM to help move their patients through the healing process. However, OWM readers also know that the very best part of April is the opportunity to attend the Symposium on Advanced Wound Care, where they can learn, first-hand, about the latest developments and newest technologies and products available for wound care. Many of the presenters are our authors and editors - a fact that underscores the significance of the articles we publish. But just as important, the SAWC provides time for you to refresh and rejuvenate as you hobnob with the gurus of wound care, earn your continuing education credits, and network with your colleagues who best understand your trials and triumphs.
My April poem has become a tradition; this April is no exception."April" comes from the Latin word aprilis--to open. I encourage you to see beyond the challenges of these first soggy weeks of Spring and open yourselves to an appreciation of re-growth inherent in the frailty/hardiness of the Earth's and its citizens' ability to restore and heal.
