From the Editor: Advancing the Art of the Science

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Barbara Zeiger

May the love for my art actuate me at all times. — Maimonides, medieval physician and philosopher

Recent issues of Ostomy Wound Management reflect the Editors’ dedication to the science governing guidelines and protocols for wound, ostomy, and continence care. Although acutely aware of the myriad of factors that must be weighed and considered, the clinicians and their proxies that decide what to put before you each month tend to lean heavily on what has been supported by research. We are mindful of regulatory and litigious issues that impact care, but for us, evidence-based information is the cream that rises to the top and underscores the care provided.

That being said, we also are perched to celebrate innovative, outside-the-box products and approaches. Some are promising but yet to be thoroughly tested and/or implemented. Others demonstrate the art involved in solving unusual problems to improve quality of life and/or encourage healing. Like Maimonides, OWM is actuated by companies and clinicians who are inspired and driven to seek ways 1) to overcome the medical/clinical obstacles that challenge us, 2) discover artful solutions to clinical problems, or 3) (not uncommonly) find that unexpected observations stimulate research or become the foundation for an entirely new way of thinking. Hence, welcome to this year’s Innovations issue.

Sometimes the art emanates from the ability to repurpose a concept, exemplified in a recent article that appeared in Science Translational Medicine1 regarding a glue, applied like a gel, that can close a wound in, literally, a minute. The glue, called MeTro (short for methacryloyl-substituted tropoelastin) is a hybrid elastic protein that can be applied to an external or internal wound. Ultraviolet light is shined to initiate the healing process. Additional newly developed products include nanofiber dressings that use proteins that naturally occur in plants and animals that can foster healing and tissue regrowth and a new dressing that resembles butterfly fasteners that are tightened and then gently released once the edges of the wound have come together. The product concepts may not be new (our Clinical Editor says she and colleagues once made similar fasteners from scratch on a hydrocolloid protective skin barrier foundation), but the developers imaginatively played with their design concepts to create a new vision. 

Sometimes the “art” is viewed through an event. The conference Wound Care: From Innovations to Clinical Trials (this year headed by OWM Editorial Board member Amit Gefen, PhD), presented in June 2018 in Edinburgh, Scotland, continues to proliferate wound diagnostic and management breakthroughs, including (not surprisingly, give its recent decriminalization for recreational use) marijuana for topical use in wound healing in Canada and an examination of the pathophysiological mechanisms common to dementia and pressure ulcers, 2 medical issues not usually examined side-by-side. Several new names were noted among presenters, boding well for the progress of this health care niche.

This issue of OWM includes innovators in their own right. Recognizing the lack of research regarding the factors that influence adaptation to an ostomy among patients in China, Wang et al2 used an ostomy product manufacturer’s database to explore why some people adjust better than others to having an enterostomy. A significant finding was that medical staff played an important role in helping the patient accept his/her new reality, a fact that suggests clinicians must employ their own creative means to connect with and support ostomates. Schwartz et al3 used a finite element modeling study to expand on previous research regarding the prophylactic use of anisotropic multilayer dressings. The dressing had been found to offer protection against pressure injury; the current study sought to discover how the dressing held up when exposed to varying amounts of moisture encountered in real-life scenarios. Wu et al4 present a case demonstration involving 3-dimensional printing used to create a splint for noninvasive use in wound care. The cost was approximately the same as a traditional splint, but it spared the patient from undergoing the painful process of manually measuring and fitting an immobilizer. We also share an article that appeared in the January 2018 issue of Today’s Wound Clinic on the innovatiove use of apps in wound clinic practice. And of course, we present the annual column, Innovations That Work! that allows manufacturers and providers to keep readers informed of the latest and greatest products and services that can be used to provide the latest and greatest care for your patients.

OWM, too, is innovating. We have updated our Instructions for Authors (incorporating the suggestions from our Editorial Board members discussed at our annual editorial board meeting) to clarify the different categories of manuscripts we accept and all the components thereof. We hope these amended instructions provide the details all authors need to sculpt OWM-worthy manuscripts and that they encourage fledgling authors to follow the guidelines and join the ranks of the published few. In addition, in January 2019 we will reveal our revamped print journal and website designs, refurbished to become even more reader-friendly and enhance our search capacity to help clinicians and researchers find and use our articles. 

OWM also will be undergoing a name change to something that better reflects our evolving role in the wound, ostomy, continence arena (this absolutely involves art in the most familiar sense!). We will cover and remain true to the same scope of practice; the new name indicates a direction. Originally, we were Ostomy Management (1981). We then became Ostomy Wound Management (1985). In 2019, we will be……

In a great deal of his medically related writing, Maimonides referred to the art of care, recognizing that healing involves as much art as science. An artist’s perception and personal creative instincts influence how he/she uses the tools at hand or comes up with new means to express his vision, just as a clinician uses ingenuity and what is available to solve health issues and optimize care. We count our readers among clinicians seeking to keep the art in the science and the science in their art. We hope that with our innovations we continue to serve you well. 

References

1. Annabi N, Zhang YN, Assmann A, et al. Engineering a highly elastic human protein-based sealant for surgical applications. Sci Transl Med. 2017;4. doi: 10.1126/scitranslmed.aai7466.

2. Xian H, Zhang Y, Yang Y, Zhang X. A descriptive, cross-sectional study among Chinese patients to identify factors that affect psychosocial adjustment to an enterostomy. Ostomy Wound Manage. 2018;64:(7):8–17.

3.  Schwartz D, Levy A, Gefen A. A computer modeling study to assess the durability of prophylactic dressings subjected to moisture in biomechanical pressure injury prevention. Ostomy Wound Manage. 2018;64:(7):18–26.

4. Wu PK, Shih YC, Chen CM, et al. Printing a 3-dimensional, patient-specific splint for wound immobilization: a case demonstration. Ostomy Wound Manage. 2018;64:(7):28–33. 

The opinions and statements expressed herein are specific to the respective authors and not necessarily those of OWM or HMP. This article was not subject to the Ostomy Wound Management peer-review process.