Dear Readers:

I am sure you have heard the old saying – “Don’t sweat the small stuff” – many times, usually quoted when we are very busy and have a million things to accomplish in a short amount of time. That is when we just decide to focus on the “big picture” and see if the rest will fall into place. Unfortunately, for the big picture to be successful, we must sweat the small stuff. Anyone who only concentrates on accomplishing the big results or the big inventions will soon have to recognize that there are many, many small parts that must be accomplished before the big result can be achieved. Also, when someone overlooks or fails to do just one simple thing, the big picture will probably fail or at least be significantly “out of focus.” There is a great story that should show us how true this can be.

Do you recall the history lesson about Napoleon and the Battle of Waterloo in 1815? The French were fighting the English and Napoleon was highly favored to defeat them. He had about 5000 more troops, 90 more cannons, and should have been able to crush the English. Sure enough, when the fight started, Napoleon’s troops routed the English and captured all their cannons. He had won the war, but the tide was about to turn. The cannons of that time were ones that had the powder followed by the cannon ball packed through the muzzle. The cannons then were fired by introducing fire through a small hole in the breech of the gun, setting off the powder, and projecting the ball outwards. In times of war, when one army captured the other’s cannons, the cannons were made useless by driving a nail through the small hole where the fire was placed. With this hole closed, the cannons could not be used. There was a group of soldiers whose only job in the battle was to drive nails into captured cannons and make sure they would not fire. Unfortunately for the French, on the day of this battle, the soldiers were unable to find any nails! Thus, they could not make the cannons useless.

As the battle raged on, some English soldiers were able to get back to their cannons and, finding them still usable, turned them on the French army. This turned the tide of the battle, allowing the English to win and go down in history as the army that caused Napoleon to meet his “Waterloo.” Due to a lack of nails, victory was turned into defeat.1

What about us in wound care? Do we sweat the small stuff when taking care of wounds? We want all wounds to heal in a short period of time and never recur. That is the big picture, but how many little things are required before this is a reality? I know that studying the wound bed and finding everything that needs to be treated is hard, labor-intensive, boring work with few rewards. Discovering the next great wound healing product is much cooler and lucrative, but without the small things, the big things will not be possible. Do you think it might be time for us in wound care to go back to sweating the small stuff?