IN THIS ISSUE OF JWOCN

One of the main pleasures of serving as your Journal's Editor is the thrill of seeing an author or group of authors publish a research report with the potential to move practice forward in a perceptible way. While the evidence supporting wound and continence care continues to accumulate at a steady pace, evidence supporting ostomy care remains comparatively sparse. The main bulk of ostomy research has focused on health-related quality of life, adaptation, and other psychosocial elements related to creation of an ostomy and living with it over a period of time. This line of research is essential, and it continues to provide invaluable insights into the management of patients living with a stoma. Nevertheless, research into the efficacy, safety, and cost-effectiveness of basic and essential interventions such as pouching and management of stomal and peristomal complications remains sparse. This issue of Journal of Wound, Ostomy and Continence Nursing (JWOCN) contains not 1 but 3 articles that meet this demanding standard. Read on to find the cutting edge of ostomy care in the premier journal for WOC specialty practice nursing!

Janice Colwell, Joyce Pittman, Rose Raizman, and Ginger Salvadalena report findings from the ADVOCATE trial. They compared cost and incidence of peristomal complications in patients using a standard ostomy pouching system versus a system with a faceplate infused with ceramide (a major endogenous component of the skin's epithelial barrier). This multisite randomized controlled trial is a must read for every nurse caring for patients with ostomies. I also hope it will serve as a challenge for other researchers to perform randomized controlled trials testing the efficacy and safety of other essential intervention used for ostomy care such as application of products with convexity, accessory products, and the effect of wear time on the long-term health of the stoma and peristomal skin.

Sirikan Rojanasarot reports findings from a cross-sectional, descriptive study that examined the impact of a postdischarge ostomy support program as an adjunct to nurse-led ostomy care on preventable healthcare utilization. This article also qualifies as essential reading because it provides novel insights into a support program that reduces the likelihood of seeking care in an emergency department or requiring hospital admission for stoma-related conditions during the first month following creation of an ostomy.

Markku Vaarala also provides a must-read report of a randomized controlled trial comparing findings obtained using 3 methods for collecting urine samples from persons living with a urostomy: (1) catheterization of the ostomy using a clean technique, (2) collection of urine dripping from the stoma, and (3) urine collected from a clean urostomy pouch. Once again, I am excited to acknowledge this clinically relevant article that expands our knowledge of a uniquely challenging component of urostomy management, collecting a proper urine specimen required to properly manage urinary tract infection.

Margaret Goldberg, Janice Colwell, Susan Burns, Jane Carmel, Jane Fellows, Samantha Hendren, Vashti Livingston, Charles Nottingham, Joyce Pittman, Janice Rafferty, Ginger Salvadalena, and Gary Steinberg deftly synthesized current best evidence and best practice in their Executive Summary of the latest update of the WOCN Society's Management of the Adult patient with a Fecal or Urinary Ostomy. This update is a must read and a perfect companion to the original research contained in this issue's Ostomy Care section.

This issue's Continence Care section opens with an analysis of the relationship between incontinence-associated dermatitis and pressure injury authored by myself and Karen Giuliano. Using data drawn from 5342 adults in 36 of the United States, this study adds to the growing and increasingly compelling body of evidence establishing incontinence-associated dermatitis as an independent risk factor for pressure injury, including full-thickness ulcers.

Elif Gezginci, Emine Iyigun, and Sercan Yilmaz report findings from their study comparing the effect of 3 instructional methods for behavioral therapy on lower urinary tract symptom severity and health-related quality of life in women with overactive bladder. You will want to read this article to determine how their findings might be incorporated into your conservative management of patients with overactive bladder dysfunction.

This issue's Wound Care section opens with a study evaluating thermal images created by a handheld unit easily adaptable for bedside use. Thermal imaging is one of a small group of technologies with the potential to enhance first-line and WOC nurses' ability to differentiate inflammation from localized ischemia and early pressure injury. The Journal of Wound, Ostomy and Continence Nursing has published prior reports examining these possible technologies,1-4 and we look forward to publishing additional research reports in the future. You will want to read this timely and clinically relevant article to determine how the findings of this study apply to this persistent and unmet clinical need, development of a noninvasive and accurate technology for detecting early pressure injury prior to development of partial or full-thickness ulcer.

Huihan Zhao, Yu He, Qin Wei, and Yanping Ying report their study of medical adhesive-related skin injury prevalence at peripherally inserted central catheter insertion sites. This article qualifies as must read because it extends the small but growing body of knowledge of this clinically relevant clinical phenomenon.

Hong-Li Chen, Shi-Jia Yu, Yan Xu, Si-Qi Yu, Jia-Qi Zhang, Jing-Yi Zhao, Peng Liu, and Bin Zhu report development of an artificial neural network for prediction of surgery-related pressure injury in patients undergoing cardiovascular surgery. You will want to read this article to enhance your knowledge of this newer investigational technique for predicting pressure injury risk models in specific patient groups and to evaluate the potential clinical applications of the model these authors built.

Daniel Gibson reports findings from an ex vivo study of 2 liquid acrylate polymers applied to skin from a pig model. You will want to read this article to improve your knowledge of the formulation of the various skin barriers and to evaluate the extent to which the findings described in this article may influence clinical application of this important leave-on skin care product.

This issue's Evidence-Based Report Card poses the question, "Does prophylactic foam dressings reduce the likelihood of developing a pressure injury of the heel?" Authored by Janet Ramundo, Caitlyn Pike, and Joyce Pittman, this article qualifies as must read because it synthesizes evidence related to the application of these dressings when used for prevention of heel pressure injuries.

This issue's Challenges in Practice feature article describes a case series of patients with calcinosis cutis. You will want to read this well-written and clinically relevant article to increase your knowledge of the assessment and management of this condition and its relationship to an uncommon but serious disorder of the blood vessels of the skin, calciphylaxis.

This issue's Getting Ready for Certification focuses on advanced practice certification in wound care. Are you ready to complete certification as an advanced practice registered nurse in wound care or WOC care? This article is an invaluable resource for achieving this important goal for many JWOCN readers.

Finally, Professor Vera Santos provides a View From Here that describes the challenges associated with WOC (and all scientific) research in Brazil. This guest commentary is particularly important because it lucidly captures the thorny issues and challenges associated with generating meaningful research in a large South American country with a challenged economy, diverse population, and a wide range of educational preparations.

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