IN THIS ISSUE OF JWOCN

Projections about the overall effect of efforts to prevent stage 3 and 4 pressure injuries are not consistently positive despite a clearly increased focus on this measure of the quality of nursing care and intense focus by WOC nurses often charged with facility-wide prevention. In order to answer this persistent question, epidemiologic evidence is needed that measures trends in the prevalence of incidence of pressure injuries over the past decade in particular. Fortunately, you can look to this issue of the Journal for a major new study reported by Catherine VanGilder, Charlie Lachenbruch, Corrine Algrim-Boyle, and Stephanie Meyer for a 10-year trend analysis of pressure injury prevalence based on care setting. In addition to carefully reading this important addition to the evidence base supporting WOC specialty practice, you will want to view the Video abstract on our Web page (JWOCNOnline.com).

Kelly Strazzieri-Pulido, Giovana Peres, Ticiane Capmanili, and Vera de Gouveia Santos provide a systematic review focusing on skin tears and associated risk factors. This article also qualifies as must read because it synthesizes existing knowledge concerning not only the incidence of these largely avoidable skin injuries; it also identifies modifiable risk factors that can provide a basis for an effective prevention program.

Evaluation of weight-bearing activities is an essential component of the assessment, treatment, and prevention of diabetic foot ulcers. Ying-Ling Jao, Sue Gardner, and Lucas Carr report a comparative study of 2 weight-bearing measurement devices in persons with diabetes mellitus and activities of healed foot ulcers. You will want to read this article to determine if the newer device described in this timely article provides a clinically superior option to prior models for assessment of weight-bearing activities in this vulnerable population.

Identification of a leg ulcer is simple, but differential diagnosis and management may be difficult, especially when the wound is caused by a mixed arterial and venous disease. Joseph Marin and Kevin Woo report findings from a descriptive study of common manifestations of mixed arteriovenous leg ulcers. You will want to read this article to enhance your understanding of the difference between mixed arteriovenous versus venous leg ulcers.

Caroline Borzdynski, William McGuiness, and Charne Miller summarize emerging technologies for assessment of skin status. You will want to read this article to enhance your understanding of advances and persistent challenges in our ability to quantitatively measure the various functions of human skin in health and illness.

This issue's Ostomy Care section opens with a report of an international consensus summit that examined use of convexity care; it was authored by Jo Hoeflok, Ginger Salvadalena, Sue Pridham, Werner Droste, Laurie McNichol, and others. You will want to read this valuable consensus document that provides expert opinion and consensus-based statements on use of various forms of convexity in persons with an ostomy.

Simon Knowles, Davina Tribbick, William Connell, David Castle, Michael Salzberg, and Michael Kamm report findings of a study that extends research into application of the common sense model for providing psychosocial support and care to persons with fecal ostomies. Knowles and colleagues1 previous article, also published in the Journal, described influences of health status, illness perceptions, and coping strategies on anxiety and depression following ostomy surgery using the common sense model. This article extends that study by examining the influence of health status, illness perceptions, and coping mechanisms that influence health-related quality of life in persons with a new stoma.

Burcu Cengiz and Zuhal Bahar report results of a phenomenological study of home care needs and perceived barriers in persons adapting to a new fecal ostomy. You will want to read this article to not only identify perceived barriers to adjustment to a new ostomy but also remind yourself of the essential role of regular care from a WOC nurse on adaptation to a new ostomy both during the initial hospital visit and when receiving subsequent home care.

This issue's Ostomy Care section closes with an executive summary of the best practice guideline for care of patients with fecal ostomies managed in the context of an Enhanced Recovery After Surgery (ERAS) model. This guideline was authored and implemented by the Enterostomal Therapy Nurse Network of Ontario and provides a structured and systematic approach for managing patients with a new ostomy as they progress from acute care facility to home care setting. This article is must read for every WOC nurse managing patients with fecal ostomies using an ERAS program.

This issue's Continence Care section opens with a description of a pragmatic laboratory-based method for evaluating bacterial growth and ammonia production in disposable absorber hygienic products. While this article has an indirect immediate impact on clinical practice, I argue it is must read for 2 important reasons; it describes current efforts to minimize odor in incontinent adults management by absorptive briefs, and it raises a persistent but yet unresolved controversy in clinical care. Read their article and anticipate more on this subject in upcoming issues of JWOCN.

Dyugu Duzkaya, Gulzade Uysal, Gulcin Bozkurt, Tulay Yakut, and Agop Citak report outcomes of a randomized controlled trial comparing catheter-associated urinary tract infection occurrences in critically ill children managed with urethral cleansing with 10% povidone-iodine, 0.05% chlorhexidine gluconate, or sterile water prior to catheter insertion. You will want to read this article because it provides clinically relevant evidence concerning the optimal means for periurethral cleansing prior to indwelling catheterization.

This issue's platform article close with an important new that expands our practice in the assessment, prevention, and management of medical adhesive-related skin injury (MARSI). Stephanie Yates, Laurie McNichol, Steven Heinecke, and colleague report on consensus-based interventions for MARSI in WOC nursing practice. This article extends McNichol and associates' original consensus document, which was aimed at first-line practitioners in all fields by identifying intervention specific to wound, ostomy, and continence nursing practice.2 This article qualifies as must read for every WOC nurse because of its focus on MARSI in our specialty nursing practice and because it provides perhaps the most detailed description of adhesive technology ever published in the professional health care literature.

This issue's Challenges in Practice discusses a prevalent but understudied challenge to wound healing, epibole. Kimberly Bare and Jerri Drain report 3 cases of nonhealing wounds with epibole managed by a polymeric membrane dressing applied in a specific manner that ensures continuous contact between the dressing and wound edge, enhancing resolution of epibole. You will want to read this innovative article to determine whether this approach may have a place in your wound care practice.

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