The Internet can provide an information cyber-link

Information growing on the Web

Anyone with access to a relatively recent-issue personal computer and a modem can take advantage of a new type of nurse’s (or doctor’s) aide — the Internet. For all of its vices, the Internet is an extraordinary resource for researching all manner of topics, including a growing quantity of wound care information. 

Another appealing aspect of the Internet is that it is very inexpensive to use. Unlimited access can be had for as low as $20 per month. And it’s at your beck and call 24 hours a day. 

Several Internet World Wide Web sites (WWW, or just "the Web") are dedicated to wound care or related areas and are continually updated with new information. Many more sites also contain information related to wound care. 

There also is growing medical development of what some call Usenet — electronic bulletin boards (also referred to as news groups, listservs, or chat groups) where you can "post" a question or comment then sit back and wait for responses from colleagues. More often than not, you’ll receive a direct answer or at least suggestions for additional resources.

Education on demand

One of the most extensive and up-to-date wound care sites on the Web is the Wound Care Information Network (WCIN), which focuses on clinical and administrative aspects of wound care. (See box, p. 78, for a list of wound care-related Internet sites.) The site is sponsored by the nonprofit Wound Care Institute in North Miami Beach, FL, and is maintained by Allan Freedline, DPM. Freedline recently joined Smith & Nephew as a clinical education and development manager, but he developed the WCIN site previously. It is not affiliated with Smith & Nephew. 

The WCIN is divided into four main areas: 

• education (including an on-line wound care course); 

• product information; 

• directory of manufacturers; 

• discussion forums (bulletin boards). 

The site also offers direct links to other Web sites that are likely to contain information pertinent to wound care providers. 

Designed to supplement the regular wound care seminars that Freedline and an associate regularly conduct, the WCIN presents an array of information: How to differentiate wound types and stage ulcers, how to document wounds appropriately, and how to apply physical therapy modalities. There is also advice about debridement options, pressure-relief options, dressings and other product categories.

The A to Z of what you need to understand’

"We’ve taken our live seminar and adapted it to the Internet — sort of the A to Z of what you need to understand before you get involved in moist wound healing," says Freedline. For example, one part of the educational section contains an explanation of how and when to use hydrogel dressings, followed by a listing of the different hydrogels on the market and telephone numbers for the manufacturers. "We’ve tried to provide a complete one-stop resource for anyone interested in wound healing," Freedline adds. 

Because the site is supported by a non-profit entity, its contents are not skewed toward one brand or type of wound product, says Freedline. 

Web sites of product manufacturers can contain some valuable information about wound care, but they are by nature biased and founded on a profit motive. 

"The average practitioner out there would get bombarded by the same few companies who can afford to put on the advertisements," Freedline says. "We took it upon ourselves to provide as fair a resource as we could with the information we had." The most informative and useful sites on the Web for wound care (and for most topics) are "built" and maintained by organizations dedicated to education, not their bottom lines.

Truly a worldwide resource

Health care professionals comprise the large majority of visitors to the WCIN, but others also have looked in, according to Freedline. "The biggest group is nurses, followed by physicians, physical therapists, attorneys, case managers, and various health care administrators," he says. Even Medicare personnel have consulted the site. About 80% of WCIN visitors come from within the United States, with the remainder spread over 40 different countries. 

A second rather ambitious and continually evolving Web site also originates at the Wound Care Institute and bears its name. It addresses numerous aspects of wound care, with a concentration on diabetic wounds. Its centerpiece is an on-line bimonthly newsletter, of which five issues have been published. Visitors can peruse back issues any time they like. Another feature of the site is a selection of books, slide shows, videotapes, and audio cassettes for rent or sale. 

Other sites of possible interest to health professionals involved in wound care are the Agency for Health Care Policy and Research (you can retrieve all of the agency’s guidelines); The Wound Management Home Page by BioMechanics magazine; Podiatry Today Online; and The National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health. Most large medical facilities and research institutions have their own Web sites that might contain information about ongoing wound care research or programs. Finding such information requires either previous knowledge of the work being done or some hunting and a lot of patience.

Want your own site? Get your checkbook

Organizations considering producing a Web site of their own are forewarned: The costs of design and maintenance can run high, especially if outside expertise must be hired. For large and intricate sites (those that are highly interactive or loaded with graphics), $100,000 or more for start up is not unusual, a Web site designer tells Wound Care. Big companies aren’t shy about spending far more. 

Then there’s the expense of maintaining the site, which can cost from a few dollars to thousands monthly. And every time the site is updated, changed or expanded, count on additional expenses. 

But it your ambitions are modest and you have someone on staff who is knowledgeable about the subject, the undertaking can be economically feasible. Fortunately for the WCIN, Freedline is an experienced Web site designer and receives no pay for his efforts. 

"If you’re considering putting a site on the Web, the first question to ask is, Do I have the skills to put it together?’ It would have been extremely difficult to put this site together if I couldn’t have done it myself. But more importantly, I have experience with physicians and nurses who are knowledgeable about wound care," he says. 

One of the mistakes evident on many medical Web sites is that they put too much emphasis on appearance, such as flashy graphics, while neglecting the product that health care professionals really want: good information they can retrieve quickly and easily, says Freedline. 

"If you don’t understand the needs of the users, then you end up with a Web site that doesn’t work too well and that constantly requires changes and upgrades."