The Association for the Advancement of Wound Care is a unique organization. As an inclusive, multidisciplinary association open to members from all over the world, regardless of specialty, background, or purpose for joining, the potential for accomplishment is as limitless as a cloudless sky in the middle of a bright and sunny day.

  When developing strategic plans, the AAWC Board has considered important questions: Does the AAWC exist only to build and help an empire of members? Or does the AAWC exist to reach out to those in need, regardless of membership?

  There needs to be a delicate balance between building membership and giving selflessly to the broader community in order to accomplish AAWC's mission to build a collaborative community that facilitates optimal care for the millions who suffer with wounds. Achieving this mission requires the support of the population served. We are calling on every reader of this AAWC special focus issue of OWM to consider the personal and professional benefits of our Association.

  Creation of a fecal or urinary diversion is common in patients diagnosed with colon, rectal, cervical, bladder, or other pelvic malignancies. Radiation therapy (RT) is one of many options available in the cancer treatment armamentarium; therefore, it is not unusual for a patient with an ostomy to undergo RT. This partnering of surgical intervention and RT creates unique challenges for the patient and healthcare provider. Three issues associated with an ostomy are most directly affected by radiation therapy: the skin, the stomal mucosa, and gastrointestinal injury.¹

Index: Ostomy Wound Manage. 2007;53(11):40-48.

  Higher rates of lower extremity amputation, coupled with an increased incidence and severity of coronary artery disease and higher cardiovascular mortality rates, are well recognized in persons with diabetes.¹ Foot and leg ulcer healing often is poor in patients with arterial insufficiency²; in people with diabetes, compromised healing is substantially increased and the atherosclerotic process accelerated.³ Although both macro- and microvascular disease are implicated in complications in this patient group, diagnosis and treatment strategies remain controversial. For example, the concept diabetic small vessel disease has long been refuted yet still appears in the literature and often results in less aggressive treatments that inappropriately lead to amputation as a primary endpoint.¹ The purpose of this paper is to provide an indepth examination of the mechanisms leading to peripheral vascular disease (PVD), as well as the role of hyperglycemia in persons with diabetes, to help elucidate potential diagnostic options, flaws in related research, and therapies that may prevent devastating sequellea.

Index: Ostomy Wound Manage. 2007;53(11):56-62.

  Foam mattresses with a thickness of 14 cm (5.5 inches) are used widely as standard supportive and pressure ulcer (PU) preventive devices in hospitals and nursing homes. Mattress quality is determined in terms of material or intrinsic factors such as density (kg/m³) or indentation (mm, inches) and derived factors such as comfort and PU prevention capability.^1,2

  It is widely recognized that mattresses have a finite life span.³ At first sight, foam mattresses of the same brand, delivered by one supplier and in use for the same period of time, may seem to be of comparable quality, although not every foam mattress would have been used the same way. Foam mattresses used for some years may exhibit visible wear and tear and “bottoming” (mattress flattened down to hard structure below) may occur.⁴ The bottoming phenomenon accelerates the risk of developing PUs because the mattress no longer reduces pressure.⁴ Thus, maintaining foam mattress quality is essential for reducing the incidence of PUs in hospitals and nursing homes.¹