There are a number of challenges that can arise when managing hard-to-heal wounds, especially in difficult to dress areas. This article explores issues that can arise in the management of chronic wounds and how these can be addressed. It also includes a case study of a deep pressure ulcer in which full healing achieved in 11 weeks. Read the full article on www.jcn.co.uk
By Kimberley Wilde Diabetic foot ulcer is a devastating complication of diabetes mellitus and can significantly impact a person’s quality of life. The lifetime risk of developing a diabetic foot ulcer is between 19% and 34% (Mcdermott et al., 2023). The Importance of patient autonomy in diabetic foot care Patient autonomy is a vital principle in health care, emphasising the right of patients to make informed decisions about their own medical treatment. There are several factors that may hinder a patient’s ability to make informed decisions about their care. Diabetic foot ulcer research has shown that patients may have a lack of knowledge of the role diabetes plays in the aetiology of a diabetic foot ulcer and patients are either unaware of, or unconcerned about, their risk of diabetes-related foot problems (Zhu et al., 2023). Many patients also felt that they had a lack of control over the risk of developing a diabetic foot ulcer Diabetes and mental health The impact diabetes has on mental health also needs to be considered. Up to 40% of patients with diabetes can experience psychological problems which can impact their ability to participate in self-management of their diabetes (Garrett and Doherty, 2014). Traditional versus collaborative care approaches When we consider patient care, it is often easy to have a traditional health care provider style. This style is often highly directive and demanding on patients to adhere to a list of behaviours. Patients tend to have little input to this “traditional style of care”. Research has shown that the collaborative approach of shared decision making between clinicians and their patients improves patient autonomy by giving patients more information and greater involvement in their medical care (NICE, 2024). Tackling barriers to patient engagement in diabetic foot treatment Research that the author conducted in 2018 (Wilde, 2018) looked at the effectiveness of a behaviour change model to enable a change in behaviour around wound care. The model called COM-B describes the three key factors capable of changing behaviour are capability, motivation and opportunity (Michie et al., 2011). This model was utilised to develop a new wound care pathway which enabled patients to be actively involved in their wound care. The key themes around shared decision making to improve autonomy were linked to each factor. Capability needs to be considered, in terms of whether the patient has the physical skills and equipment to be actively involved in their wound care. To enable capability, the patient needs to be given education to increase their knowledge around the wound and the disease process that caused it. Opportunity is a situation in which it is possible for you to do something that you want to do. In relation to wound care this may be having support from family and/or friends or the use of a leaflet/video which explains how to effectively clean and change a wound dressing. Health Care professionals play a crucial role in promoting patient opportunities and empowering them to take an active role in their own healthcare. Patient motivation There are several factors that could impact a patient’s motivation. Motivational interviewing is a skill that clinicians can use to enhance patient engagement and facilitate positive behaviour change. Empowering patients using motivational interviewing The key elements of motivational interviewing are building rapport, using open-ended questions and affirmations, reflective listening and summarising. The use of motivational interviewing enables healthcare staff to create a supportive environment that empowers patients to take charge of their health (Pennock, 2023). By implementing the strategies described healthcare providers can foster a sense of autonomy in patients, leading to better management of diabetic foot ulcers and improved overall outcomes. References Bu, F., Fancourt, D. How is patient activation related to healthcare service utilisation? Evidence from electronic patient records in England. BMC Health Serv Res 21, 1196 (2021). https://doi.org/10.1186/s12913-021-07115-7 McDermott K, Fang M, Boulton AJM, Selvin E, Hicks CW. Etiology, Epidemiology, and Disparities in the Burden of Diabetic Foot Ulcers. Diabetes Care. 2023 Jan 1;46(1):209-221. doi: 10.2337/dci22-0043. PMID: 36548709; PMCID: PMC9797649. Michie, S., Van Stralen, M. M., & West, R. (2011). The behaviour change wheel: A new method for characterising and designing behaviour change interventions. Implementation Science, 6(1) National Institute for Health and Care Excellence, Shared Decision Making, 2024 Pennock S., Revolutionize Nurse-Patient Relationships: Motivational Interviewing for Nurses, 27th December 2023 Wilde, K, Self-management shared care wound care pathway, Wounds UK, June 2018, Vol: 14 | Issue: 03 Wilde K, "Patients' perceptions of self-management of chronic wounds." Wounds UK 16.3 (2020). Zhu X, Lee ES, Lim PXH, Chen YC, Chan FHF, Griva K. Exploring barriers and enablers of self-management behaviours in patients with diabetic foot ulcers: A qualitative study from the perceptions of patients, caregivers, and healthcare professionals in primary care. Int Wound J. 2023; 20(7): 2764-2779.
Health care professionals have had a tough few years with reducing resources, overstretched staff, and the impact of the Covid pandemic. Understanding Motivation and Resilience How do we find the motivation and resilience to rebuild ourselves, find a way forward, lead our teams and support our patients safely and effectively? Motivation is the driving force behind human actions. Cherry (2023a) describes motivation as “the process that initiates, guides and maintains goal- orientated behaviours.” Cherry suggests two types of motivation exist- extrinsic and intrinsic. Extrinsic relates to rewards- e.g. praise or recognition for your work and intrinsic relates to our internal attributes- feeling satisfaction in completing something or doing well. Resilience is the ability to cope and recover from setbacks (Rice, 2022), manage our available resources and find ways of managing situations we face. Resilience is also knowing when we need help and seeking it. Motivation and resilience can be impacted by physical, psychological and social influences, including stress or being overwhelmed by the workload. We may diminish our own motivation and resilience with self-doubt and self-criticism. External influences such as criticism of our work, lack of gratitude can also deplete our motivation and resilience. A lack of motivation can lead us to avoid progress and doubt our abilities. We need to recognise the factors that influence and block our own motivation, only then can we manage these and move forward. A resilient person has a fighter/ survivor mentality. They regulate their emotions; this doesn’t mean being unemotional or not losing control but understanding that these things pass and can be managed. The resilient person has good problem-solving skills, but also encourages others in solving problems through compassionate leadership, good communication, teamwork and support (Cherry, 2023b). Factors Affecting Motivation and Resilience Bailey and West (2022) describe that people need their core needs supporting in the workplace to feel well, motivated and resilient, these are- Autonomy- controlling one’s work life; acting within one’s values with authority, empowerment and influence; and working in a just and fair environment with good working conditions and workloads. Belonging- being connected, valued, respected and cared for by colleagues; and supported within a team with good leadership and culture. Contribution- experiencing effectiveness at work and recognised for their contribution, having access to education, learning and development through good management and supervision. Alongside these, the Chartered Institute of Personnel and Development (CIPD, 2022) steps to ensuring well-being in the workplace add: Health- physical and mental health and safety Ethics and diversity Lifestyle choices- access to physical activity, healthy eating in the workplace Financial well-being- pay/ benefits, retirement planning, childcare support In healthcare, leaders also use human factors alongside understanding core needs to study impacts on staff behaviour, motivation and resilience; these incorporate- Environmental (the physical workspace/ personal space), organisational (work patterns, culture, resources, communication and leadership) Job factors (nature of work, workload, procedures and policies), Individual characteristics (competence, personality, behaviours) An organisation with well-being at its heart has motivated and resilient staff with higher morale and engagement and are likely to have a better work-life balance. Compassionate leadership that includes supporting all these aspects has been shown to increase staff retention and support a healthier, more inclusive environment. Individually, we can increase our own motivation and resilience by understanding and acting on the things that block or impede our progress, using past experiences to help us grow and to support others in their journeys. We can- Adjust goals, break tasks into smaller chunks so things don’t appear so big and impossible to achieve. Prioritise the important things, achievable things and things that give satisfaction. Remind ourselves of achievements, strengths and how we can use these to progress. Be our authentic self, maintain our identity References Bailey S., West M (2022) What is compassionate leadership? Kings Fund. www.kingsfund.org.uk/insight-and-analysis/long-reads/what-is-compassionate-leadership Chartered Institute of Personnel and Development (2024) Wellbeing at work. CIPD. www.cipd.org/uk/knowledge/factsheets/well-being-factsheet/#the-key-domains-of-wellbeing Cherry K (2023a) Motivation: the driving force behind our actions. Very Well Mind. www.verywellmind.com/what-is-motivation-2795378 Cherry K (2023b) How resilience helps you cope with life’s challenges. Very Well Mind. www.verywellmind.com/what-is-resiliance-2795059 Rice A (2022) What resilience is and isn’t. Psych Central. www.psychcentral.com/lib/what-is-resiliance
At the 35th Conference of the European Wound Management Association (EWMA 2025) in Barcelona, Flen Health was proud to contribute to the advancement of wound care by showcasing a series of e-posters and presentations. These were developed by - and in close collaboration with - dedicated healthcare professionals (HCPs) who use and trust Flaminal®in their daily practice. As part of our mission to support science-driven, patient-centered wound care, we’re pleased to share the abstracts that served as the foundation for these contributions. These abstracts offer valuable clinical insights and practical guidance for professionals across the wound care community. Compiled in the document below, the abstracts highlight the real-world impact of Flaminal®, demonstrating its antimicrobial protection, versatility, and ease of use. They illustrate how innovative wound care solutions can support clinicians in addressing the complex, evolving challenges they face every day. Featured Abstracts (in English and Spanish) Include: Enabling Patient Empowerment: The Impact of Versatile Dressings on Wound Healing and Quality of Life – A Case Series Addressing Antimicrobial Resistance in Wound Care: A Quality Improvement Project Investigating Stewardship Navigating Challenges in Treating Extensive Wounds: Insights, Best Practices, and Clinical Guidance from a Case Series Evaluating Hydro-Active Colloid Gel for Preventing Deterioration of Incontinence-Associated Dermatitis in Critical Care Use of Enzyme Alginogel in Complex Traumatic Wounds in Pediatric Patients: Clinical Cases Navigating High-Risk Pediatric Wound Care: 20 Years of Clinical Insights Bridging the Gap: Accessible Wound Care for the Homeless Community Wound Follow-Up with Enzyme-Alginogel Ointment in Neuroischemic Diabetic Foot Wounds Optimización del protocolo de curas en heridas oncológicas complejas: un enfoque basado en la evidencia y casos clínicos Nuevo enfoque en el tratamiento de las quemaduras pediátricas con el uso de alginogel enzimático Alternativas a la cirugía: estrategias de manejo conservador Cierre de herida isquémica crónica infectada tratada con alginogel enzimático Con casco y en pantalón corto: la ayuda del alginato hidratado Enfermería y cuidados compartidos: pilar clave en el tratamiento multidisciplinar de la gangrena de Fournier Herida compleja en lesión postquirúrgica de un año de evolución Pediatric Burn Injuries: A Multidisciplinary Protocol Implemented in a Tertiary Center in Spain Tratamiento de quemaduras de espesor parcial con alginogel enzimático antimicrobiano Úlcera por presión (UPP) asociada al uso de dispositivos médicos Comparison of Enzyme Alginogel vs Standard Care in the Treatment of Burnt Hands Click on the link to consult EWMA GNEAUPP 2025 Conference Abstracts and Presentations This collaborative initiative reflects Flen Health’s deep appreciation for the HCPs who consistently go above and beyond in their clinical practice - and our commitment to supporting them with effective, evidence-based solutions. We extend our heartfelt thanks to all the contributing professionals for their trust, dedication, and expertise. Together, we continue to meet the challenges of wound care and strive for better outcomes for patients around the world.
Pressure ulcers impact around 12.8% of patients worldwide yet are preventable in up to 95% of cases with timely intervention and care (NHS, 2022). Pressure ulcers form due to prolonged pressure on the skin, which restricts blood flow and damages underlying tissues. Bony areas of the body are particularly vulnerable. While pressure ulcers can lead to extended hospital stays, infection, and increased healthcare costs, early detection significantly reduces these risks (NICE, 2014). Identifying pressure ulcers in the early stages can often be challenging, especially in patients with darker skin tones. The Importance of Early Detection Early-stage pressure ulcers, identified as category 1 or 2, involve the outer layers of skin and, with appropriate care, can be managed. Timely identification allows healthcare providers to implement strategies such as repositioning and using pressure-relieving surfaces to prevent further tissue damage (NHS, 2022). Once pressure ulcers reach the later categories (3 and 4) they take longer to heal and may require further intervention. This can lead to much more pain, a higher risk of infection, and a significant impact on quality of life (AHRQ, 2013). Why Pressure Ulcers Are Harder to Spot in Dark Skin Tones Unfortunately, pressure damage can often be missed in dark skin tones, primarily due to a lack of education and awareness around early signs of pressure damage across different skin tones. In light skin, a common erythema, or skin redness, is often more visible during the early stages of pressure damage. For people with dark skin tones, however, erythema often appears as hyperpigmentation. According to some research, healthcare providers may underreport or even overlook early-stage pressure ulcers in patients with dark skin tones, which can lead to missed treatment opportunities and the pressure injury unnecessarily progressing to more severe stages (Saghaleini et al., 2018). Additionally, “non-blanching erythema” - skin redness that doesn’t turn white when pressed - a classic sign of pressure damage, is also less visible on dark skin tones. Non-visual Indicators of Pressure Damage Across Skin Tones As well as recognising that colour changes show up differently on different skin tones, it is also essential for caregivers and healthcare providers to assess the skin for other indicators of pressure damage (NICE, 2014). Skin texture changes, like skin sponginess, are common with pressure injuries. This can occur over bony areas like the hips, heels, and elbows. In both light and dark skin tones, this texture change is felt rather than seen and should prompt immediate interventions to prevent further damage. Pressure damage can also lead to temperature changes in the skin, manifesting as cooler or warmer patches as a result of impaired blood flow. Temperature variations are easily detectable through gentle touch, which should form part of thorough skin assessment. Finally, itching and irritation can be an early indicators of pressure damage and patients should be encouraged to report any areas of skin discomfort promptly, especially in areas may be at risk for ulcer formation. Awareness and Education To ensure the early detection of pressure ulcers in all skin tones, a more holistic approach to awareness and education is essential. Education and guidance for healthcare providers and caregivers on how to recognise the more subtle signs of pressure ulcers, and how these may differ across different skin tones is important to ensuring equitable care. Encouraging patients and caregivers to regularly inspect high-risk areas for any unusual skin changes, looking for both visual and non-visual cues, is critical to implement early intervention and prevent more serious pressure damage occurring. References Agency for Healthcare Research and Quality (AHRQ). (2013). Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices. National Clinical Guideline Centre (UK). The Prevention and Management of Pressure Ulcers in Primary and Secondary Care. London: National Institute for Health and Care Excellence (NICE); 2014 Apr. (NICE Clinical Guidelines, No. 179.) 8, Skin assessment. Available from: https://www.ncbi.nlm.nih.gov/books/NBK333153/ National Institute for Health and Care Excellence (NICE). (2014). Pressure ulcers: Prevention and management. http://www.nice.org.uk NHS England. (2022). *Stop the Pressure: Pressure Ulcer Prevention. http://www.england.nhs.uk NHS England. (2022). *Stop the Pressure: Pressure Ulcer Prevention. http://www.england.nhs.uk Saghaleini, S. H., Dehghan, K., Shadvar, K., Sanaie, S., Mahmoodpoor, A., & Ostadi, Z. (2018). Pressure ulcer and nutrition. Advanced Biomedical Research, 7(6), 1-10. Young C (2021) Using the ‘aSSKINg’ model in pressure ulcer prevention and care planning. Nurs Stand 36(2): 61-6
Undergoing radiotherapy can have many side effects, one of which is radiation-induced skin reactions (RISR). These reactions can be easily spotted when the skin colour changes or becomes itchy. However, skin reactions can differ in appearance across different skin tones, and visual cues such as redness are not always applicable to patients with brown or dark skin. Radiation induced skin reactions (RISR) are a common side effect from external beam radiotherapy. There are different intrinsic and extrinsic factors such as smoking status or chemotherapy that can increase the severity of a radiotherapy skin reaction1. Skin colour changes, itchy skin, skin tightening, oedema, and pain are some of the symptoms of RISR1. Within radiotherapy, one the widely used toxicity scoring tools is the Radiation Therapy Oncology Group (RTOG)1. However, this scale, like many others, have a bias to assessing white skin tones with limited research and evidence of their use for brown and black skin tones2-3. These tools along with medical education use terms such as erythema or redness to evaluate RISR2-3. A key limitation with the term erythema is that while underneath the skin, it physiologically signifies an increase of blood flow to an area, externally this can present differently across a variety of skin tones. In 2021, the British Association of Dermatology (BAD)4-5 described erythema as misleading as it can present as different changes in the colour spectrum such as purple or yellow in appearance or show the affected area become darker than the surround area. As mentioned before, whilst redness is true for people with white skin tones, people with black skin, however, may see the treatment area to go darker than their normal2. Other changes across the colour spectrum may also occur, including yellow, purple, grey, or maroon2. While some people with brown skin may see some redness, maroon colour changes, along with the area becoming darker than their normal, is more common2. Evidence has found that ample lighting on the affected area will help reveal more subtle changes6. More importantly for people with black skin, where visual cues are more difficult to see, touch is an important prognostic tool as the skin can become tighter, harder, and warmer to touch due to post radiotherapy skin changes2. In other dermatological conditions, such as pressure ulcers, it has been well documented that relying on only visual cues will disadvantage diagnosis and appropriate assessment with black skin as early cues are not as visible when compared to their white counterparts6. Importance of respectful and inclusive language Evidence suggests that using inappropriate terminology may be discriminating against people of colour2,6. Using terms such as ‘brown’ or ‘black’ has been found to be more professional and respectful rather than saying someone is ‘darker.’6 Calling a person of colour ‘darker’ only implies that they are different to the norm of being white. Asking the person in front of you what they prefer their skin to be addressed is important to aid a successful relationship when assessing their skin2,6. Overall, it is important to remember that ‘redness’ does not work for everyone, take time to learn about who the person front of you is and use prognostic tools where possible. References The Society College of Radiographers. Radiation Dermatitis Guidelines for Radiotherapy Healthcare Professionals. The Society College of Radiographers. Report number: 1, 2020. Julka-Anderson N. Structural racism in radiation induced skin reaction toxicity scoring. J Med Imaging Radiat Sci. 2023 Oct 11:S1939-8654(23)01872-6. doi: 10.1016/j.jmir.2023.09.021. Julka-Anderson N, Thomas C, Harris R, Probst H. Understanding therapeutic radiographers’ confidence in assessing, managing & teaching radiation induced skin reactions (RISR): A national survey in the UK. Radiography. 2024 April 25:30(3)978-985. Doi: 10.1016/j.radi.2024.04.006. British Association of Dermatologists (2021) Describing erythema in skin of colour. Available at: https://www.bad.org.uk/healthcareprofessionals/ inclusivity- and- representation/erythema- in- skin- of- colour [Accessed 28th September 2022]. Wounds UK (2021) Best Practice Statement: Addressing skin tone bias in wound care: assessing signs and symptoms in people with dark skin tones. Wounds UK, London. Andrews E, Nair, HKR, Pearson J, Dhoonmoon L, Wijeyaratne M, Waheed M, McConnie S, Abbas Z. Wound care and skin tone: Signs, symptoms and terminology for all skin tones. Wounds International; 2023.
What is EWMA? EWMA ( European Wound Management Association) is a nonprofit organisation that focuses on advancing wound care and promoting interdisciplinary collaboration throughout Europe and beyond. The association organises an annual conference, the EWMA Congress, which serves as a platform for healthcare professionals, researchers, industry representatives, and policymakers to exchange knowledge, discuss innovations, and address challenges in wound care management. Flen Health on EWMA Conference From May 1st to May 3rd, Flen Health proudly participated in the 2024 EWMA Congress, held in London. It was incredible to have the opportunity to learn more about the latest innovations in this field of healthcare and connect with so many people involved in the wound care sector from around the globe. At Flen Health, our mission is to revolutionise wound management through innovative solutions that prioritise patient comfort, efficacy, and ease of use. The EWMA Congress, as always, provided an ideal platform for us to showcase Flen Health as a company and our mission. Throughout the event, our team had the pleasure of engaging with so many people who share our passion for advancing wound care. Each interaction was an opportunity to learn, collaborate, and inspire. A big thank you to those who visited the Flen Health stand We were incredibly grateful for the warm reception we received and would like to extend our gratitude to everyone who visited us at the EWMA Congress. Together, we are shaping the future of wound care management for the better. Thank you once again for being part of our EWMA Congress experience. See you next year at 35th of EWMA Conference that will take place on 26th - 28th of March 2025 in Barcelona, Spain
On the 23rd February 2024, the JWC awards ceremony was held at the Imperial War Museum in London. This ceremony celebrates the hard work, dedication and achievements of leading individuals and organisations within the field of wound care. Industry partners have the opportunity to sponsor an award, to further recognise and support this work. Antimicrobial Stewardship Recognition Flen Health sponsored the ‘Antimicrobial Stewardship’ category. As concerns surrounding antibiotic and antimicrobial overuse and resistance continue to rise, antimicrobial stewardship has become increasingly important. This award category acknowledged organisations, researchers and health care professionals promoting the appropriate use of antimicrobial dressings, as an alternative to antibiotics for wound infections. About Flen Health Flen Health began as a company in 1999, with its first product, Flamigel ®. In 2005, Flaminal ® was launched for acute and chronic wounds, and wounds at risk of infection, offering a novel approach to manage wound exudate, aid autolytic debridement and reduce bioburden. Flaminal ® is composed of a hydrated alginate matrix, a debriding gel and a unique antimicrobial enzyme enzyme system. This system consists of two naturally occurring enzymes, glucose oxidase and lactoperoxidase, stabilised by guaiacol to kill a range of gram positive and gram negative bactera and fungi1. The enzyme system is non-cytotoxic, as it only acts on bacteria absorbed into the gel matrix, and to this date no instances of antimicrobial resistance to the enzyme system have have been recorded2. On behalf of all at Flen Health, we want to congratulate those shortlisted for this award, and the winner: Iva Pranjic. References 1. De Smet, K. et al. Pre-clinical evaluation of a new antimicrobial enzyme for the control of wounds 2. Gottrup F, Apelqvist J, Bjarnsholt T et al (2013) J Wound Care 22 (5): S1-S92 bioburden. Wounds. 2009, 21(3): 65 - 73
In the scope of marathon running, few stories are as fascinating as that of Koen Naert, a Belgian athlete who seamlessly blends the worlds of professional running and nursing. This article breaks down Koen's extraordinary journey, highlighting his evolution from a spirited young runner to an experienced marathon professional with a unique background in healthcare Koen recounts his early passion for running, painting a vivid picture of his progression from a young enthusiast to an experienced marathon runner. The unexpected twist of working as a nurse at the burns centre while entering the marathon world is unveiled, showcasing the support that propelled him towards a professional athletic career. "First, I was a runner because I started running when I was six years old. I evolved from a five to ten-kilometer runner, to a cross-country runner to a marathon runner,” said Koen. Flamigel®: A Familial Connection and Professional Integration: Koen shares his first encounters with Flamigel®, drawing parallels between familial habits and the reliability of this wound care product. The integration of Flamigel® into his professional healthcare career becomes evident, underscoring its familiarity and importance in Belgium's medicine. “Flamigel® is a very familiar product in Belgium and everyone has it in the medicine closet." Balancing Nursing and High-Level Sports: When asked about his partnership with Flamigel®, he had the following to say, “In life, I have three passions: my family, marathon running or just running, and healthcare. And as an athlete and healthcare ambassador, I want to tell a story. I want to be able to inspire and motivate people, not only in running but also in healthcare. I realized I could do that together with Flamigel®.” He added, “This partnership allows me to do some nice storytelling and to be very authentic...I want people to know that behind the professional runner, I am a healthcare professional." Koen reflects on the uniqueness of combining nursing and high-level sports. The intense study period, combining a bachelor's degree with a professional athletic career, shapes his resilient mindset. His experiences in healthcare, particularly in a burn care centre, become a source of mental strength during challenging training moments. “I take with me on difficult days the resilience of those patients who fought for their healing," he said. Contributing to Public: Concerning his recent experience in Kenya, Koen shares how impactful this experience has been, emphasizing his gratitude for the hospitality. His vision of contributing to public health in Kenya through education and wound care projects is shown, showcasing his dedication to making a lasting impact. "I hope in the future we can do something bigger and meaningful to help the people in Kenya - that would be my big goal and a big dream." Life Philosophy and Balance: The insights gained from the burn care centre guide his approach to training, promoting a balance between determined boundaries and respecting individual pain thresholds. According to him, "Don't be afraid to dig deep, but always be careful and listen to your body. I think that is something I learned from wound care." But how does he balance his passion for running and healthcare? Koen shares his philosophy on life balance, prioritizing family, marathon running, and healthcare. His commitment to continuous learning, pursuing postgraduate studies, and maintaining a balance between athletic pursuits and nursing studies is unmistakable. "Balance in life is very important. I want to stay updated so that when my marathon career ends, I am ready to enter the working field as a healthcare professional again." Advocacy for Proper Wound Care: Koen underscores the necessity of proper wound care, expressing concern that even healthcare professionals may lack essential knowledge. As an ambassador, he aims to provide accurate information and raise awareness about the fundamentals of wound care. In conclusion, Koen Naert's journey is a testament to the fusion of passion, resilience, and a commitment to make a positive impact in both the marathon world and healthcare. As he continues to inspire and educate, his unique story serves as an example for aspiring athletes and healthcare enthusiasts alike, highlighting the extraordinary possibilities that unfold when two worlds seamlessly collide.