1. Thompson, Julia RN, BSN, CWOCN

Article Content

This issue of Critical Care Nursing Quarterly (CCNQ 25:1) is devoted to the topic of maintaining and restoring skin integrity in the critical care patient. The inception of this issue was my observations that (1) in the face of the acuity and complexity of the critical care patient, close nursing assessments and interventions related to skin integrity are easily overlooked, and (2) with the increasing number of products and treatments available to promote wound healing, the decision concerning what to choose has become confusing for the clinician.


Initially, my intent was to publish an article for the critical care nurse on this topic of skin/wound management. With discussion, it became clear that, in fact, the subject was worthy of an entire issue. With many thanks to Carmen Germaine Warner, MSN, RN, FAAN, I was linked with the editorial staff of CCNQ, who graciously and enthusiastically supported the idea.


Thus, with the generous help and contributions from my colleagues locally and throughout the nation, we have created this issue. The reader can view these articles as essentially a primer for skin and wound management. The aim is to provide the critical care nurse with background information on how wounds heal, factors that delay healing, and assessment parameters, principles, and products to optimize the patient, both systemically and at the integumentary level. The reader will see the need to resist the tendency to focus immediately or only on the wound itself. The nursing processes of assessment and planning precede intervention even for a shallow tissue injury.


The goal of this issue is also to increase the reader's awareness of the potentially devastating implications for the patient if a pressure ulcer is allowed to develop. It is universally accepted that the adage "an ounce of prevention is worth a pound of cure" is apropos in regard to pressure ulcers. However, in the literature, the cost of pressure ulcers, both in terms of patient suffering and economics, are documented as astronomical.


The critical care patient is at great risk for the development of a pressure ulcer secondary to immobility combined with often multi-organ system failure. With this situation and in the absence of adequate pressure relief, a pressure ulcer will form and deteriorate in a time frame as short as a few hours. Nursing plays the pivotal role in protecting patients from pressure ulcer formation. It is the nurse who can and must readily identify the patient who is at risk and ensure implementation of the simple, yet profound, preventive measures.


The authors and myself thank you for your attention to this issue of CCNQ. The nurse who becomes more knowledgeable on the subject of skin and wound management will become more competent in providing care. This is rewarding for both you, the nurse, and your patients!