I n January 2003, the Canadian Association of Wound Care (CAWC) decided to take a bold step. The membership had been saying that access to both physical and human resources for managing chronic wounds was a major issue — that while the demand for services to treat chronic, nonhealing wounds was rapidly expanding, it did not seem to be a funding priority at various levels in the healthcare system. The CAWC Research Committee had been saying that in order to set research priorities, the extent of chronic wounds in Canada had to be determined.

To address these concerns and better advoca

C aring for patients along the geriatric continuum, Scott Bolhack, MD, CMD, FACP, conceptualized a vision of care management. In his mind’s eye, he sees medical practice as a painting, a work in progress where he helps fill in the gaps. Some physicians here, a nurse practitioner there, a social worker, a registered nurse, a wound care specialist. This is no random sowing of healthcare providers, however. Through planning, steady growth, and the employ of experienced professionals, Dr. Bolhack’s Tucson Long-Term Care Medical Group has earned a presence in 19 of the 21 nursing homes in the T

C linicians working in wound care appreciate how life for individuals with wounds is disrupted by care, cost issues, and the pain associated with treatment. Although managing pressure ulcers is often a passion for wound care specialists, the majority of the population is unaware of the challenges involved and many healthcare professionals place little emphasis on identifying and treating skin ulcers. The number of individuals seeking wound care services continues to grow, which suggests that pressure ulcers are a relatively common healthcare concern and an escalating problem. Statistics are av

Look at the patient lying long in bed.
What a pathetic picture he makes.
The blood clotting in his veins,
the lime draining from his bones,
the scybola stacking up in his colon,
the flesh rotting from his seat,
the urine leaking from his distended bladder,
and the spirit evaporating from his soul.
— Dr. Richard Asher, British Medical Journal, 1947

S ince Dr. Asher recorded his observations,¹ many studies have documented the impact of bed rest. In article after article, the reader is cautioned to heed the severe complications of bed rest as a treatment modality.