To the Editors,

I am a home health nurse with a critical care background practicing in North Carolina. I have always been interested in wounds and hope to complete WOC nurse certification some day. I read with interest the supplement focusing on the use of foam dressings. As you may guess, we see many chronic wounds in home health, especially in bed bound patients. I have 2 such patients; the first is a young man with severe lupus and multiple wounds on his lower extremities, and the second is an elderly woman who suffered a paralyzing stroke 16 years ago and has multiple pressure ulcers. I had managed to get all but the worst wound healed on the young man. That wound extended from his knee to his ankle, and involved the shin and inner part of his lower leg. After reading this issue, I switched first to Xeroform (Kendall Healthcare, Mansfield, Massachusetts) and foam, and then foam by itself. In 4 weeks, I was able to discharge the patient, based on successful wound closure. This outcome is significant since he had been receiving care for almost a year. We anticipate that wound healing in older patients will take longer, but changes have been remarkable. A female patient had 9 discreet wounds, including 3 that were managed with VAC. The remaining wounds were making slow progress toward healing using an alginate dressing. However, a change in dressing was needed owing to a reduction in exudate volume and slight desiccation of the wound beds. Based on the understanding I gained from reading this issue of the Journal, VAC was discontinued and we dressed these larger wounds with a foam dressing. Within 3 weeks, both of the larger wounds had closed and I changed from alginate to foam on 3 other wounds. One has closed and I anticipate that the other 2 will close in another week to 10 days. The patient's physician is pleased and the family is thrilled with her progress. So, thank you very much for such a timely and informative issue-it has certainly made a difference in 2 lives, and I have passed on the articles and my success to my other team members!!

Colleen Stevens, RN