So Many Choices

The world lost one of its most cherished athletes last year, Arnold Palmer. He truly was a champion in the golf world and a great ambassador for his sport worldwide. There were many impressive things about Mr. Palmer that caught my attention, but one that certainly was amazing was that at the time of his death, Mr. Palmer owned approximately 14 000 golf clubs, including 2500 putters! Those are astonishing numbers since the rules of golf only allow 14 clubs to be in a player’s bag during any given round. Most professional athletes are very possessive of their equipment and will only change clubs, rackets, or other equipment if made to do so or if something extraordinary comes along. Apparently, Mr. Palmer was just the opposite. It is reported that when he won the Colonial National Invitation Tournament in 1962, he used a different set of irons in each of the 5 rounds he played! He was always looking to improve his game by finding better equipment, and he never tired of testing different clubs and different versions of clubs. Mr. Palmer was always excited about the new and innovative, especially if it would give him an edge.¹ 

How does that apply to wound care? For one thing, it is always nice to hear stories of very successful people who continue to strive for improvement in whatever endeavor. Each day is a chance to improve or to find a better way. I think that should apply to wound care. No matter how successful we are at identifying and treating patients with wounds, we should always be searching for a better way. As you know, our most successful treatments fall short of healing everyone. We still have not found the “magic bullet” that will provide universal success in treating wounds.  

It also is nice to hear someone who realizes that every shot in golf is unique, requiring a slightly different club or approach. Unfortunately, in golf, there cannot be a club for every individual circumstance. That is what makes the sport a challenge. In wound care we have several thousand products from which to choose to treat a patient. If we want to get the best result for the patient, we have to do our studies to understand the wound and what it needs to improve. If only it were that easy! Every wound is different and every person with a wound is different. I have said many times that if you would pick 100 patients you felt had identical diabetic foot ulcers and treat them exactly the same way, you would get 100 distinctive outcomes. I don’t think that is much of an exaggeration, if at all.  

Each of us has a unique genetic makeup, unique comorbidities, and unique abilities to manage a wound (compliance). These determine how a wound will respond to a particular treatment. If the wound does not respond to one therapy, a second should be tried, then maybe a third or a fourth. This is why it is imperative that we have multiple therapies available to treat wounds. Also, we should never quit evaluating different treatments to help our patients. Until we have the diagnostic tools to tell us exactly what the wound needs and when, we are left to rely on evidence-based care and our own best judgment.  

People try to tell us we don’t need so many wound treatments — just get a protocol and follow it. Sounds good, but that doesn’t always provide the treatment each specific patient needs. I know I don’t have all the treatments I need to successfully heal all wounds. Like Arnold Palmer, we must keep trying new and different things in an attempt to meet the needs of each individual patient’s wound.