Failure? Maybe Not!

As health care providers, we pride ourselves on providing the best, up-to-date, evidence-based care to every patient to heal their wounds or at least improve their quality of life. When we are able to accomplish this, we feel like we have done our job. Many of us have been very fortunate to give presentations on wound healing. When we do these presentations, we talk about certain products or techniques that show our successes in wound healing. One evening, after what I thought was a sterling presentation, a physician in the audience asked me, “Do you ever treat a wound that does not heal?” I assure you that question let the air out of the room. Of course, I answered that I probably have had as many patients whose wounds did not heal as everyone else; I just had not presented them at conferences. He was satisfied with the answer, but I began thinking about the patients whose wounds I have had the most trouble healing and even those few that have not healed. What have I been able to do for those patients? What have I learned from those cases? 

One of the first things I learned is that failure should be instructive. When I have had unsuccessful answers and treatments, it leads me to investigate the literature and reach out to consultants to try to learn what might be helpful. Many therapies from the past have fallen out of favor and are rarely used today—not because they do not work, but because newer, cooler therapies have been developed; that is a lesson I learned many years ago while reading the history of diseases and their original treatments. You may find that when today’s therapies do not work, are not appropriate, or are not available, the old-time treatments may give you other effective options.  

Another resource we have at our disposal is to talk to others in the field. People talk at meetings about many different subjects, such as general lecturers who show significant experience treating the problems about which they lecture. Why should you not ask for help from them? When I was starting to enter wound care full-time, I contacted numerous “experts” in one subject or another for help. Never was my request for help turned down. Do not be afraid to seek help and contact others. Not only can you gain some great, helpful information, but it can also lead to the development of great relationships. My mentors from years past remain my friends to this day. 

A second thing that failure has taught me is to simply stop, review the case from top to bottom, and try to figure out why things are not progressing as expected. It is amazing what you might discover with this approach. As you assemble your information, ideas may come to you as to what you might have overlooked or what might be helpful. I have done a moderate amount of what would be called clinical research in my wound care career. The majority of my research ideas have resulted from my thoughts about what might improve a treatment problem. If you have a fresh idea, look it up in the literature to see if someone else may have had the same thought and already done the hard work to know if the idea is a good one. If no one has thought of your idea before, contact a mentor to see if the idea has merit. If it does, see what you can do to test the idea through your own clinical research. There are plenty of mentors who can guide you down that path—always remember that no one will laugh at your ideas, and you do not need to be the premier clinician to have good ideas. For instance, no one had ever heard of Drs Banting and Best before they discovered insulin to treat diabetes. 

The third lesson from failure is to not give up hope that you can help your patient. You and your treatment may be the only hope your patient has, so use the aforementioned tips to provide the best possible outcome for your patient’s problem.  

In the end, remember, failure can be considered a success if it is used as a learning experience. 

Author: Terry Treadwell, MD, FACS

Correspondence: woundseditor@hmpglobal.com