From the Editor: Year’s End Reflection

  As we’ve prepared this last issue of Today’s Wound Clinic for 2012, I’m realizing how fast this year has progressed. We hope that you have enjoyed this year’s editions as we plan topics for 2013. We face an ever-changing regulatory and reimbursement environment, and one undisputed fact is that care provided to our patients as we move forward must continue to be driven by evidence-based standards that incorporate measurable quality outcomes. The TWC editorial board is committed to bringing you timely, thought-provoking content. As always, we welcome articles, suggestions, and requests from you, our readers and peers.

Compression Compilation

  The focus of our current issue is one that has significant relevance to all of us in outpatient wound clinics — the management concerns that impact the care of the patient living with chronic venous insufficiency (CVI) and ulcers. CVI patients, as well as those living with diabetic foot ulcers, undoubtedly comprise the majority of those in our care and present with challenges that negatively impact quality of life.   The wonderful part of caring for these patients is the rate that we can heal these ulcers without incident when we invoke sound treatment plans that include adequate compression and focused wound management (and a willing patient).   To that end, we have written several articles focusing on this care. In “Chronic Venous Insufficiency: Pathophysiology and Treatment,” Kathryn C. Durham, MD, and Adelaide A. Hebert, MD, tackle the complexities of CVI on page 30. My fellow board member Susie Seaman, NP, MSN, CWOCN, and I discuss strategies for compression during the treatment phase of the patient encounter and what to do for an ulcer that’s closed to assist long-term healing and avoidance of recurrence in “The Importance of Compression in the Outpatient Wound Center” on page 10. Matthew Livingston, BSN, RN, CWS, ACHRN, also provides insight related to what’s happening under compression bandaging in his article “Skin & Wound Management Under the Wraps” on page 24.   You’ll also find ways to improve your business when providing the appropriate type of compression in conjunction with other procedural services such as debridement or the application of biological products in the regular “Business Briefs” column by Kathleen Schaum, MS, on page 6. Additionally, Peggy Dotson, RN, BS, covers coding for the use of total contact casting for the management of diabetic foot ulcers in “Efficacious Treatment of Diabetic Foot Ulceration With Total Contact Casting” on page 17.

Year’s End Reflection

  I recently had the special opportunity to spend time with my true mentor Evonne Fowler, RN, CNS, CWOCN, after a lecture trip to California. We had a wonderful time and spent a lot of time talking about the specialty of wound care. We reflected on how far we have grown, how wound healing has become multidisciplinary (though still with room for growth), and how very lucky we are to have our career pathways continue as they have. Confucius said, “Choose a job you love, and you will never have to work a day in your life.” I think that is how everyone I have ever met who practices wound healing looks at their career.   Wishing all of you a wonderful, safe holiday season and a most happy New Year! Dot Weir, RN, CWON, CWS, co-editor; dorothy.weir@hcahealthcare.com