From the Editor-in-Chief
For a period of 5 years I had the pleasure of serving as Director of the WOCN Society's Center for Clinical Investigation. Part of my responsibilities in that position were generation of Evidence Based reports Cards, an early form of systematic review. One of the most frustrating areas to address was nursing management and interventions for patients with ostomies; best practices were typically based on tradition and clinical experience rather than evidence. In this issue of JWOCN, a physiotherapy colleague, Sarah Russell provides a View From Here describing her advocacy of early resumption of physical activity, followed by a comparatively aggressive approach to restoration of physical activity over the longer term. While this intervention is supported by only sparse evidence, clinical experience strongly suggests the positive impact of physical activity on abdominal wall tone, physical health in general, and health related quality of life. I strongly encourage you to read this lucid and rationale feature, and consider investigating the claims made by Russell in the context of your own practice.
An example of this sort of scholarly work is provided in this issue's Clinical Challenges article authored by Susan Solmos, Olga Radkevich-Brown and Cynthia Lafond that outlines three cases originally characterized as deep tissue pressure injury (DTPI) but ultimately diagnosed as purpura fulminans and septic vasculitis. You will want to read this article to expand your understanding of purpuric lesions and to remind ourselves of our role within an interdisciplinary team that often incudes input from a dermatologist. I also encourage to summarize your experience with DTPI in an article in an upcoming issue of JWOCN.
I hope to see each of you in Nashville at the WOCNext!
Mikel Gray, PhD
Russell S. Exercise After Ostomy Surgery and Peristomal Hernia: A View From Here. Journal of Wound Ostomy & Continence Nursing 2019; 46(3):215-218.
Solmos S, Radkevich-Brown O, LaFond C. Differentiating Deep Tissue Pressure Injury (DTPI) From Other Causes of Purpura in the Sacrococcygeal Area: A Multiple Case Series. Journal of Wound Ostomy & Continence Nursing 2019; 46(3):256-262.