Volume 26 Number 2

Dear Dr Bjarnsholt,

Thank you for your eloquent and thought-provoking reflections on EWMA 2025. Your honesty and insight are deeply valued, and your words offer both a challenge and an opportunity for collective introspection.

As you rightly pointed out, this year’s conference brought together an unprecedented 6264 participants from 90 countries—an indication of just how global and urgent the issue of wound care has become. With 850 oral presentations, 1547 e-posters, and contributions from 143 exhibitors, EWMA 2025 represented one of the most extensive and diverse programmes in our history. These numbers are not just statistics—they reflect a community deeply engaged, actively learning and openly sharing.

The EWMA conference structure has deliberately transformed in response to evolving needs over the years. We have moved away from three days of continuous slide presentations and toward a more dynamic, participant-focused model—combining high-level lectures, hands-on workshops, debates, Q&A-driven sessions, and interactive formats. This change has been overwhelmingly well received: out of 2,524 participants responses collected, 93% of attendees reported that the conference met or exceeded their expectations, 95% approved of the session formats, and 96% stated that they would apply what they learned in their clinical practice on a daily or weekly basis. Additionally, 94% indicated that the exhibition was relevant to their work, offering new insights, tools and collaborations.

We appreciate your spotlight on Dr Contreras-Ruiz’s session and the revealing lack of consensus around antimicrobial stewardship. It is a vivid illustration of the current state of flux within our field—where strong opinion often stands in for solid consensus, and where clinical practice is shaped as much by gaps in evidence as by its presence. You are right: This is a call to action, one that requires the combined efforts of clinicians, researchers, industry, and policymakers. The search for clarity must be relentless but also grounded in humility.

To that end, antimicrobial stewardship has been a strategic priority for EWMA since 2013. In collaboration with the British Society for Antimicrobial Chemotherapy (BSAC), EWMA has developed tailored AMS guidance for wound care professionals, focused on prudent antimicrobial use and infection prevention. We have also launched a fully updated e-learning course in 2024 on Antimicrobial Stewardship in Wound Management—designed to equip healthcare professionals with knowledge on resistance mechanisms, diagnostic approaches, and responsible antimicrobial application. Furthermore, EWMA plays an active role in EU-JAMRAI 2 (2024–2027), a coordinated European effort to support national action plans on antimicrobial resistance. Through this and our growing body of publications, we aim to drive both awareness and practical implementation across all care settings. Additional details are available on EWMA webpages (Antimicrobial stewardship - EWMA) if you would like to participate in these activities, and we would welcome any additional ideas for potential collaboration.

That said, it’s also important to acknowledge the wider breadth of themes that EWMA 2025 brought to the forefront. Alongside antimicrobial stewardship, we saw growing attention paid to areas that have traditionally received less focus, such as atypical wounds, hidradenitis suppurativa, and palliative wound care. These sessions opened up new dialogues and expanded our collective understanding of what wound care must encompass—beyond infection control, toward comprehensive, patient-centred approaches.

You raise a crucial point about the mismatch between what we understand biologically (such as the role of pH, immune modulation, and oxygenation) and what is implemented in clinical routines. This gap between evidence and practice remains a core concern for EWMA, and one we will continue to address—not only by supporting the generation of new data, but by creating the platforms through which it can be meaningfully translated into clinical pathways.

If there is confusion in the field, it is not a failure—it is a sign of vitality. We believe that creating space for disagreement, diversity of methods, and challenging debate is essential to advancing care. Your voice contributes meaningfully to that mission. The metaphor of the “elephant in the room” is apt, but so too is the image of a global community coming together in pursuit of better answers, clearer pathways, and more reliable outcomes.

As we look forward to EWMA 2026 in Bremen, we carry your reflections with us—as a reminder of the urgency of our work, the complexity of the challenges we face, and the value of speaking truthfully about both.

With sincere appreciation for your engagement and enduring contributions to the field,

Andrea Pokorná
Scientific Recorder
European Wound Management Association (EWMA)

Author(s)

Andrea Pokorná^1,2
1Department of Health Sciences, Faculty of Medicine. Masaryk University
²Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University

Email apokorna@med.muni.cz