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​​​From the  Editor

I want to pose 3 clinically relevant and timely questions for our WOC, F&N caring community. 

Question 1: Is it safe and effective to use a pouching system with convexity during the first week following ostomy surgery? Is it safe to use convexity during the first 30 days following hospital discharge following ostomy creation?

For the answer to these questions, you should first read the article by Stoia-Davis, Colwell, Emodi, Fellows, Mahoney, McDade, Porten, Raskin, Norman, Kelly, and Sims who report findings from a cross sectional survey of more than 300 clinicians with expertise in ostomy care including certified Ostomy and WOC nurses and colorectal surgeons concerning use of convexity following stoma surgery. Then read the paired article from Colwell, Stoia Davis Emodi, Fellows, Mahoney, McDade, Porten, Raskin, Sims, Norman, Kelly and Gray that sum​marizes consensus-based statements and a new best practice pathway for use of convex ostomy pouching systems during the postoperative period following stoma surgery.  ​​

Question 2: What is the Information, Motivation, Behavioral Skills (IMB) model and how can it be applied to first-line (behavioral) management of overactive bladder dysfunction (OAB)?

For the answer to this question, read the randomized controlled trial from Tuzer, Gezginci, and Yilmazer that compares usual OAB management to a behavioral intervention using the IMB  model in a group of adult males with OAB dysfunction and urge incontinence. No matter your focus within the WOC and Foot & Nail caring community, you will want to read this to determine whether this model may serve your needs for patients with a variety of wound, ostomy, continence or foot & nail disorders.

Question 3:  I have heard that acetic acid exerts broad antimicrobial actions on gram negative and positive pathogens, but can also be cytotoxic. Does it paly a role in topical therapy for chronic and indolent wounds colonized with Pseudomonas?

This complex question is answered by Chen and Zhou who describe a multiple case series of adults with chronic and indolent wounds managed by acetic acid soaked gauze in this issue's Clinical Challenges Section.  You will want to pay attention to both the concentration of acetic acid when used as topical therapy, along with  the strategic timing of this therapy and its discontinuation.

Have more questions, look to JWOCN for cutting-edge and evidence-based answers!



Use of a Convex Pouching System in the Postoperative Period: A National Consensus

Colwell, Janice C.; Stoia Davis, Janet; Emodi, Krisztina; More

Journal of Wound, Ostomy and Continence Nursing. 49(3):240-246, May/June 2022.

2021 Guideline for Management of Patients With Lower-Extremity Wounds Due to Diabetes Mellitus and/or Neuropathic Disease: An Executive Summary

Bonham, Phyllis A.; Brunette, Glenda; Crestodina, Lea; More

Journal of Wound, Ostomy and Continence Nursing. 49(3):267-285, May/June 2022.