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Global Curriculum for Wound Management

There is a need for a global curriculum for wound management. Accidents and their consequent management are very common and cost governments and individuals far more than they can afford. There is a need for the teaching of best practice, which in the case of the first aid of wounds, has been led for more than 100 years by the Red Cross Society and the St John Ambulance Brigade in the developed world. The best practice management for wounds and burns after the initial first aid, can be derived by an examination of several systems of medicine. Best practice is not owned by the developed world alone. However, in all systems advances in the understanding of the whole complex biology of wound healing and particularly from elite centres in the developed world, is not yet influencing for the better the majority of wounds and burns. One reason for this is that all practitioners in the field over emphasize their favourite agents for the management of wounds. These self same agents might well be more effective if other important aspects of management were not so commonly omitted. For example, in a recent survey in Manchester-', it was shown that nurses are managing leg ulcers by using one or two agents from a list of about 148, and yet, less than half the nurses had the skills of bandaging to control the principal causes of the ulcers, namely venous hypertension. It is known that nurses in the UK use the latest most expensive dressings, but some also use traditional remedies, such as honey or yoghurt. The cost of ineffective management of wounds to the UK for leg ulcers alone is estimated at £236 million per annum. This problem is being addressed by producing blueprintsof good management and trying to steer nurses away from believing that the cure for a wound is their particular favourite dressing. In the developing world, in rural areas there is probably always a favourite plant for the immediate management of a wound or burn. The list of plants in the paper which follows on herbal remedies in Nepal (pp 44-46) illustrates simply how numerous these agents may be, and one can be fairly certain that the traditional healer, who has a favourite remedy, would probably use it more effectively if such treatment were combined with best practice from an integrated global curriculum. Such a curriculum should include accident prevention, the immediate first-aid of the wound and burn, best 31