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Editorial

Making It Christmas Every Day

December 2016
1044-7946

Dear Readers:

Christmas is nearly here again. It seems like only yesterday we were dealing with the onslaught of television and print commercials showing us the latest and greatest that we should be buying as presents for friends and family. Last year certainly showed us all gifts are not created equal. Remember the hoverboards that were the thing to have last year? Now they are banned from most places because the battery catches fire! Maybe we should readjust our giving plan and think of more permanent things to give instead of just more “stuff.” Since the majority of us have all the things we need, how about a donation to a charity in a person’s name? I was very honored last year when someone gave a goat in my name to an international charity. (No comments about me being an “old goat” please.) To help someone in need should be our greatest calling, and we as health care providers do that on a regular basis. But, is there anything more we could do?  

As I travel the world, treat patients with wounds, and try to educate local providers on how to manage wounds, it has dawned on me that we have a great gift we could give to those in need.  And it is free! It’s wound care education. Yes, it has been said by one of our older physicians: “wound care is medicine’s gift to the poorest of the poor.” Some of the most common problems managed by health care providers in underserved countries of the world are wounds. Burns and traumatic wounds abound, diabetic foot ulcers are an epidemic, and nonhealing, operative wounds are a continuing source of disability. There are few providers trained in the management of wounds of any type, and this includes physicians. The lack of appropriate therapy is a continuing source of disability and even death in these countries. The mortality of diabetic foot ulcers has been reported to be as high as 53% in one African country.1 The cost to treat these ulcers often is so high that it prevents people from seeking any therapy.

It’s up to us to present new information in a way that will convince the provider that our recommendation is better than what they have been doing. The patient must do better with the “new” way rather than “their” way.  The “new” way must be just as easy or easier to do than “their” way. The “new” way must be cheaper than “their” way. If it is not cheaper, it certainly can’t be more expensive and must be more effective. Even with those goals accomplished, patience is imperative. Studies have shown new techniques can take up to 10 years before they are automatically included in medical practice, thus replacing old practices.2 Follow-up visits and additional teaching are critical if our basics of wound care are to be accepted over current practices.  

Despite the challenges, helping providers in under-resourced countries accept modern wound care principles is a life-changing gift, with far-reaching results that can impact individuals, communities, and even countries. The gift of wound care training can make every day Christmas for many.

Merry Christmas and Happy Holidays!

References

1. Ogbera AO, Fasanmade O, Ohwovoriole AE, Adediran O. An assessment of the disease burden of foot ulcers in patients with diabetes mellitus attending a teaching hospital in Lagos, Nigeria. Int J Low Extrem Wounds. 2006;5(4):244-249. 2. Ericsson KA, Charness N. Expert performance: its structure and acquisition. American Psychologist. 1994;49(8):725-747.

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