Dear Readers,

Historically, the apothecary was the professional charged with making perfume. He would mix the best, most fragrant spices and resins to assure the most outstanding fragrance possible. His instruments of choice for producing the sweet smelling products were the mortar and pestle. As he stood at his workbench the sweet smell of the mixture would permeate the shop. Since there were no windows or window screens, flies and gnats were soon swarming around the mortar. Occasionally one of the winged visitors would get too close to the mixture and become trapped. The apothecary would stop and remove the insect along with some of the mixture. This always frustrated the worker because it cost him time and money to stop the work to remove the insect and to throw out even a small amount of the precious perfume. If he was not paying attention or chose to ignore the gnats, one or some of them could be mixed into the fragrant mixture. If this persisted, the fragrance of the mixture was soon not so sweet. With time and laziness on the part of the apothecary, the fragrant mixture began to stink from the dead insects now included in the perfume. Soon it was worthless and the entire mixture had to be discarded at great expense to the apothecary.

Has this ever happened to you in the care of your patients? All wound care providers (I recently heard us referred to as “woundologists”) strive to do the best for our patients, to provide “pure, sweet smelling” treatments. Unfortunately, we may feel that cutting corners “just a little” will make our lives easier and will not make any difference in the outcome. Maybe we can skip the debridement this visit. Perhaps we can save some money for the wound center if we choose a second-line dressing. The complete history can be skipped today since there is so much else to do. There are many other examples, but shortcuts are always taken with the rationale that it will not matter if it is done “occasionally.”

Just like with the perfume, once we begin to ignore one or two “little things” in patient management, it becomes easier to ignore the more important things until soon we are not practicing good wound care. One day we suddenly realize that our “perfume” stinks—the care we are giving is not helping. It is time to throw the “perfume” away and start again with the renewed goal of providing the best care available. Evaluating one’s own outcomes may be the place to start because it can be an eye-opening experience pointing to areas where too many “insects” may have become “trapped.” To find the best available practices, a practitioner may need to review one of the many recently published wound care books. Reading journal articles can sharpen one’s acumen for current wound care therapy. A review of current guidelines for care will illustrate evidence based care. Attending local, regional, or national wound care meetings can provide current information and new contacts, which can be invaluable resources. We must do whatever it takes to return to the idea that the purpose for our work is the patient and the goal is to provide quality, evidence based care for each. Remember, for many of them we are already the “last resort” for any chance of healing. Let us not become lazy or indifferent when caring for our patients. We want our “perfume” to provide patients with the “perfect fragrance” they need.