Teaching Wound Care in Cambodia

We had the opportunity to teach wound care at both the Sihanouk Hospital Center for Hope and the Kossamack Hospital in Phnom Penh. We did an assessment of learning needs before we put together a "Wound Care Primer". Cathy taught the anatomy and physiology of the skin, phases of healing, type of healing and cellular response.

Cathy Teaching anatomy and physiology of the skin

Mary taught acute and chronic wound assessment, infection vs colonization, wound measurement and proper swabbing technique.

Mary teaches wound management

Mary also taught negative pressure wound therapy rationale and application technique. All the health care staff that we met here in Phnom Penh are very interested in NPWT (VAC). We were told the VAC dressing were originally brought by a physician 4 years ago and they continue to get supplies donated by many individuals and sources. Sihanouk had VAC dressings available to them including Versa foam, but no working pump.   They use Gomco suction and it is quite effective.  Kossamack Hospital was a different story.  They had the granufoam and that was about it.  They use plastic wrap, packaging tape and a suction tube.  This is connected to a fish tank pump and large glass suction container.  They are presently trying to source a sponge that is similar to the granufoam that will be effective to use for NPWT.  Their biggest challenge is sterilizing the sponges they source in the market that don't disintegrate in the high heat.

Mary teaches Negative Pressure Wound Therapy by Papyra

In order for Mary to provide hands on experience and demonstrate the application of the VAC, we were able to get a Papaya (largest fruit here) and we simulated a wound by cutting out the flesh of the fruit.  This turned out to be a very effective teaching tool because we found that the language barrier was more of an obstacle than we expected and that pictures and hands on learning was much more effective in teaching.  Mary demonstrated the VAC application and procedure, but soon realized that this was a learning moment for her as she had never used plastic wrap, packing tape and suction tube connected to a fish tank pump.  We were amazed that when all was done, a seal was attained and the sponge sucked down beautifully.  It was a wonderful teaching moment for all involved!

Mary teaching application of NPWT on a papyra

We had more senior nurses attend our educational session at the Sihanouk but were amazed to have 30 Nursing students, 4 staff nurses and the head surgeon attend at Kossamack.
As mentioned previously, we had to speak very slowly and use pictures as a frame of reference due to the language barrier. We also had to stop frequently to ask for translation on certain sections that we could tell the group was not understanding. We received very positive feedback from both groups - they seemed to grasp our concepts.  We in turned were thrilled to be able to share our knowledge while integrating their supplies and overcoming the obstacles of being countries apart, yet all dealing with the same goal....effective wound care.

Cathy teaching Nurse Educators  wound care