IN THIS ISSUE OF JWOCN

This issue of the Journal covers the scope of WOC practice, from pressure injury prevalence in pediatric patients to leakage in persons living with ostomies to a clinical trial of a skin protectant for management of severe incontinence-associated dermatitis (IAD), and a case study of medical adhesive-related skin injury (MARSI) following appendectomy. In this Context for Practice, I will begin with a description of this issue's Ostomy Care section. Jane Fellows, Louise Lalande, Lina Martins, Anne Steen, and Zenia Storling compared rates of leakage from ostomy pouching systems in a cohort of persons living in North America to a cohort residing in Europe. You will want to read this article to learn more about difference in the likelihood of experiencing leakage based on geographic area and associated worry related to these events. Barbara Kuczynska, Adam Bobkiewicz, Adam Studniarek, Krzsztof Szmyt, Lukasz Krokowiza, Konrad Matysiak, Jacek Szmeja, Jaroslaw Walkowiak, Michal Drews, and Tomasz Banasiewicz report an exploratory study of conservative management in individuals with colostomies and symptoms of constipation. You will want to read this article to learn more about this novel approach to fecal elimination symptoms in persons with colostomies and their stepwise approach to its conservative management.

This issue's Wound Care section is also packed with cutting-edge articles stretching the boundaries of wound care practice and strengthening the evidence for well-established practices. Ivy Razmus and Sandra Bergquist-Beringer report a study that evaluated pressure injury prevalence in children care for in an acute care setting. This study qualifies as must read because it explores an understudied aspect of pressure injury, its epidemiology in the pediatric population, along with factors associated with facility-acquired pressure injuries. Tonya Moyse, Jacqueline Bates, Matthew Karafa, Angela Whitman, and Nancy Albert report on a validation study of a 10-factor model for predicting pressure injury risk in patients with vascular diseases. You will want to read this article to determine whether this model might enhance your ability to measure pressure injury risk in patients with vascular diseases.

Layla Garrigues, Juliana Cartwright, and Donna Bliss report a study that examined nursing students' attitudes about pressure injury prevention. The success of any unit-wide, facility-wide, or health system-wide pressure injury prevention program in large part relies on active collaboration with bedside nursing colleagues. You will want to read this study because it describes how nursing students, tomorrow's first-line nurse colleagues, form their initial attitudes toward pressure injury prevention. Maude Lavigne, Isabelle Reeves, Marie-Josee Sasseville, and Christine Loignon report development and initial validation of 2 instruments designed to identify and explore factors associated with adherence to offloading practice for prevention and management of diabetic foot ulcers. You will want to read this article to see if one or both of these instruments might be applicable to your practice or your ongoing clinical investigations into this vitally important aspect of WOC nursing practice.

Cynthia Padula, Heidi Paradis, Robert Goodwin, Judith Lynch, and Deborah Hegerich-Bartula report results of a quality improvement project for prevention of medical device-related pressure injury in critically ill patients using respiratory care equipment. You will want to read this important article not only because it explores care in an underserved area of WOC nursing but also because it challenges us to strengthen the sparse evidence base concerning the prevention and management of these largely avoidable injuries. Lisa Hultin, Estrid Olsson, Cheryl Carli, and Lena Gunningberg report their study of the use of a pressure mapping device for prevention of pressure injuries. Pressure mapping is a well-known device in the research arena; this article qualifies as must read because it evaluates the possibility of widespread clinical application for this technology.

Nasir Khatri, Shuhao Zhang, and Santosh Kale report on current techniques used for postoperative monitoring of microvascular free flaps. This pragmatic and insightful article combines a cogent review of traditional techniques with a concise description of cutting-edge technology for early detection of vascular compromise in these flaps, ultimately resulting in the prevention of graft necrosis and loss. This issue's Wound Care section closes with a View From Here from William Padula and Mary Beth Makic that summarizes their expert opinion about the essential role of informal leadership in the construction and maintenance of a successful pressure injury prevention program; need I say more about its relevance to WOC practice?

This issue's Continence Care section opens with a study reporting incidence and predictors of IAD in nursing home residents with new-onset fecal and/or urinary incontinence. Donna Bliss, Michelle Mathiason, Olga Gurvich, Kay Savik, Lynn Eberly, Jessica Fisher, Kjerstie Wiltzen, Haley Akermark, Amanda Hildebrandt, Megan Jacobson, Taylor Funk, Amanda Beckman, and Reed Larson share findings from a study that evaluated records from a cohort of more than 10,000 elderly nursing home residents who developed incontinence and IAD. You will want to read this article that provides valuable insights into the incidence of IAD and associated factors, including pressure injuries and not having an IAD prevention program. Mary Brennan, Catherine Milne, Marie Argell-Kann, and Bruce Ekholm report findings from an open-label study of the effects of a skin protectant on management of IAD. This study qualifies as must read because it explores an especially sparse area in IAD, management of severe skin damage.

Alexander von Gontard, Tom de Jong, Jasmin Badawi, Kathleen O'Connell, Ann Hanna-Mitchell, Anka Nieuwhof-Leppink, and Linda Cardozo authored a comprehensive review of psychological, physical, and environmental factors influencing development of incontinence in adults and children. You will want to read this well-written article that deftly summarizes current knowledge concerning these often overlooked factors and to identify the multiple areas of research needed to improve WOC nursing practice in this area of continence care.

Your Clinical Challenges feature article is authored by Sylvia Britt, Karen Coles, and Shannon Polson. They report a case study of MARSI (skin tears) in a 67-year-old woman with hypersensitivity to adhesives. Their insightful narrative illustrates the critical need for expanding our knowledge and practice focusing on prevention and prompt management of MARSI, as well as the consequences of these clinically relevant and largely avoidable injuries.

Laurie Ellefson, Francis Wilson, Kathleen Hoffman, Belinda Wells, and Melissa Gonzalez authored this issue's Getting Ready for Certification article. This edition of the well-known and popular section in JWOCN is our first epub exclusive article. This exciting new feature enables us to expand the breadth of material offered to you with each issue while using the latest technology to ensure that JWOCN remains the official publication of the WOCN Society and the premier source for wound, ostomy and continence practice across the globe.