A Collaborative Wound Care Initiative in Lucknow India

Patients are required to pay for supplies, medication, and food, but they are too poor to afford these items. The hospital makes and autoclaves their own 2X2 gauze pads. Every wound was dressed daily with normal saline soaked gauze. Many patients refused pain medication and lay there with tears streaming down their faces as the dried gauze was removed from their wounds. The nurses did not wear gloves and floor sweepers emptied patients’ drains while they were cleaning the floors.

The goals of the collaboration were to assess post surgical wound care practices in a tertiary referral center in India and to provide educational seminars to the surgeons and nurses at the facility.

To assess post surgical wound care practices, the team met their first objective of understanding current practices of complex wound care (open abdomen) at the center. They evaluated the surgical infection control standards, based on the WHO guidelines, as well as current medical and nutritional management of surgical patients in a 60-bed surgical gastroenterology unit and a 30-bed ICU. Current nursing practices of postoperative wound, drain, and ostomy care were also assessed. 

The objectives for the second goal were based on preparing and presenting continuing medical and nursing education seminars. These seminars focused on complex wounds, infection control, tubes, drains and ostomy care. The team conducted a weeklong continuing medical education seminar for the surgeons on complex abdominal wounds, infection control standards, nutritional and medical management of the surgical patient. The team also conducted a weeklong continuing nursing education seminar on the care of postoperative wounds, drains and ostomies. New technologies and wound products for difficult wounds were introduced. Examples of such are negative pressure wound therapy and debriding ointments. Standards of care for wounds in the US, which are not widely practiced in India, were discussed.