From the Editor: Meet the Editors

   Welcome to the inaugural issue of Today’s Wound Clinic. This journal was developed to address the specific needs of clinicians and administrators of outpatient wound clinics — a growing segment of providers managing patients with wounds that require on-going care. We invite you to meet the two professionals responsible for the inception and oversight of this publication. Although they humbly profess the serendipitous nature of their professional achievements, their combined years of education (received and provided), managerial and patient care experience, and mutual respect make them the perfect team to launch and sustain TWC.

Dot Weir, RN, CWON, CWS:

   Reflecting back on my 31 years as a nurse, I am in awe of the opportunities that have come my way, many through hard work but some by just being in the right place at the right time and knowing the right people. The most pivotal was a fall day in 1979. My Nursing Director asked if anyone wanted to attend a 3-day ostomy school taught by a wonderful nurse, Anita Kotheimer. Attending this seminar set the stage for my involvement in a richly rewarding specialty where I have learned something new each and every day.

   Over the years, I have worked in acute care, long-term care, and home care. I spent 7 years in industry where I learned about the business of healthcare and traveled the country meeting wound healing thought leaders and researchers — teachers and providers of evidence, respectively. Then my soulmate and colleague Karen Durigan gave me the opportunity to manage an outpatient center — responsibilities that have brought the kind of fulfillment that will carry me until retirement. Five years later, I was helping a hospital in Kissimmee, Fla open an outpatient wound clinic. Now a year after arriving, my clinic partner Dr. Walter Conlan and I are practicing in a hospital system with all of the right ingredients: supportive administration, an outstanding and growing group of nurses from different specialties, a skilled physical therapist, and a supportive, “patients first” front office duo.

   Why outpatient practice? Outpatient care demands multidimensional, multidisciplinary approaches. To the patients, we are not only nurses, therapists, and physicians, but also case managers, social workers, and friends. In many cases we become part of the family. We enable people struggling with painful wounds for a short time or for years to see hope in the face of the pain and uncertainty. We save limbs, restore lives, proliferate dignity. We become the go-betweens with physicians. We are patient advocates, healing not only tissues, but also spirits.

   Many clinicians in outpatient care feel they are practicing in a vacuum. They need to reach out to and learn from others who share similar practice, reimbursement, and patient concerns. This is the goal of Today’s Wound Clinic. Whether your practice is individually run or part of a management group, whether it is free-standing or housed in a room in a larger facility, there is much to learn from each other to further this specialty within a specialty. The need for outpatient wound care services needs to be firmly established with community physicians, payors, and patients; providing outpatient wound care in a cost effective manner will ensure clinic survival for years to come.

   We encourage your comments and suggestions for information to augment and support outpatient wound care practice. I am proud to be part of the wound clinic community and this important endeavor.

Caroline Fife, MD; President, Intellicure, Inc.

   The truth about my career as a wound expert bears uncanny resemblance to the story of an infamous inorganic chemistry professor. His discovery of an important synthetic material was a complete accident (a la “Flubber”), with the brilliant flashes of insight added later.

   In 1990, after a fellowship in Undersea and Hyperbaric Medicine, I was hired as the Director of the Hyperbaric Medicine Unit at the University of Texas Health Science Center, Houston. I knew a great deal about hyperbaric medicine but little about chronic wounds. As the patient referrals began, I knew many did not need hyperbaric oxygen therapy. But what did they need? When I explained to my Chairman that someone needed to open a wound center, he said, “That would be you.”

   With no textbooks, no courses, no management companies, no consultants, and few dressings, a wound care center was opened. While completing my fellowship at Duke, I had spent time (truth be told, 2 days) with leg ulcer specialist Dr. Claude Burton. We used his four-page handout, “How to manage venous stasis ulcers” (it featured the concomitant use of the Unna’s boot and DuoDERM® (ConvaTec, a Bristol-Myers Squibb Company, Princeton, NJ), known as “The Duke boot” as a template to open our wound center. Soon we were changing 15 Unna’s boots before lunch (with a healing rate of 85%, I might add). In the largest medical center in the world, in the fourth largest city in the US, we were the only “wound center.” Our volume attracted pharmaceutical companies, affording us the opportunity to do clinical trials for many well-known products and devices.

   Not long after, a diabetic foot clinic, a lymphedema clinic, and other services were added — usually, with my reluctant approval because I would need to attend yet another meeting outside of my comfort zone to improve my familiarity with additional wound care techniques. I am proud to say that after 17 years, the Memorial Hermann Center for Hyperbaric Medicine and Wound Care is one of the premier programs in the US. I would like to say it was all due to my incredible foresight, but now you know the truth. It is often said that the definition of intelligence is the ability to learn from experience. If that is true, the definition of wisdom is the ability to learn from the experience of others. We hope that is what this journal will do for you — allow you to learn from the experience of others to gain knowledge the easy way. Think of it as experience in your pocket.