Wound healing in the developing world.

Most would recognize that nonhealing is due to malnutrition, infection, or failure of blood supply, but in practice in a world in which there is now much understanding of how to manage nonhealing, the real issue is how to direct this knowledge so that it becomes available to all. There is a failure of delivery of care. When considering quality of life issues, people's preferences, priorities, and motivation have to be taken into account, but this can be applied also to the deliveries of care. Caretakers must want to relieve odor and pain and help the mobility of their patients, encouraging them to be well groomed, allowing them to maintain adequate hygiene by bathing and, above all, making them welcome so that they can be embraced, can marry, and can be employed. To achieve these goals, complete healing is necessary with normal color, contour, and function. Management of wounds in the third world requires missionary zeal for some basic objectives. Nothing can be taken for granted. There must be food and drink for the patient, protection from flies, antisepsis, good surgical technique, a temperate environment, and a knowledge of the requirements for achieving one's potential in each and every community.