Still in Search of a Name

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Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of Wounds or HMP Global, their employees, and affiliates

One question: What would you like to be called?

That is one of the first things we ask our patients, yet no one knows what to call us.

I am a plastic surgeon. Previously we called ourselves Plastic and Reconstructive Surgeons. Then the Society decided that was redundant, and perhaps too much of a mouthful, so it was truncated to Plastic Surgeon. As cosmetic surgery took off, including use of injectables, a segment of the profession wanted to bring back the reconstructive term so that the population at large would understand the breadth and depth of what we do. To this day most people do not know the origins of the term plastics, yet they have a reasonable idea of what a plastic surgeon does, and in general (especially when their child has a facial laceration), the profession is respected for a high level of skill and knowledge.

But what about wounds? Is there a term that fully represents the breadth and depth of what wound specialists do? We are called upon to prevent and properly diagnose wounds, treat dead and dying tissue, prevent and treat infection, and identify and diagnose skin diseases including rashes and skin cancers, etc. The tissue we treat is way more than skin deep and encompasses every area of the body. I call myself a wound surgeon and I am proud of it, but there is more to it than just surgery. It is an interdisciplinary field that requires comprehensive knowledge of wound pathophysiology, but also a comprehensive understanding of the multiple chronic conditions and systemic diseases that affect patients with wounds. Furthermore, our patients can be very young, not so young, and very old.

What should the scientists who research wounds and inflammation that contributes to wounds call themselves? They are unlocking the keys for the clinicians who will ultimately be providing personalized medicine for people with wounds. They deserve a special name.

And what should wound centers call themselves? Are they “caring” for wounds, “treating” wounds, or “healing” wounds? Which wound centers are comprehensive and which are not, and who decides? Is it possible to portray to the public that the treatment encompasses a system of care that includes a hospital, a center that specializes in wounds, all the medical specialties needed to fully treat the patient with the wound, and the nurses who bravely go to their homes?

As we look across the globe and back in time for a perspective on nomenclature, it’s helpful to recognize that this neglected field has often searched for a name. Terms have been proposed: Woundology¹ was proposed as early as 2008 and Vulnerology,² meaning an action or remedy that helps to heal wounds, was proposed as a hybrid of Greek and Latin in 2014. This term might also be interpreted as treating the vulnerable, which most wound clinicians aspire to. In the United Kingdom, you might be referred to the Tissue Viability service and be treated by a Tissue Viability Nurse, while the Society for Tissue Viability encompasses a broad community of those who have a passion for solving issues related to skin and wound challenges.

Consider the origin of the word rheumatology. This field of medicine is quite diverse, but the common element is inflammation, yet they agreed upon a term that describes watery fluid or discharge that flows combined with the suffix that means ‘the study of.’ Given that the goal of wound clinicians and scientists is to heal, perhaps we should consider the Latin root sano, in which case the field would be Sanatology and the clinicians Sanators.

Noting that at least 30% of hospital beds are occupied by people with wounds, it seems logical that a field devoted to treating these wounds should be a recognized specialty with all the accoutrements such as board recognition, fellowships, dedicated time in the medical curriculum, inclusion in staffing targets and representation on scientific panels, and possibly even higher pay. Unfortunately, a similar logic did not work out for geriatric medicine, another interdisciplinary specialty that appears to have an obvious importance and need for our aging population.³

So, what would you like to be called?

• Woundologist
• Vulnerologist
• Tissue viability specialist
• Wound specialist
• Curandero/a
• Wound whisperer
• Sanator (from the Latin ‘to heal’)

The field needs a name so that we can push for inclusion in early medical training, develop a standardized curriculum, and garner funding to promote our future leaders. We look forward to a healthy and productive discussion.

Lisa Gould, MD, PhD, FACS