Individuals with wounds deserve quality care and outcomes even if they live in low-resource settings (LRS). Those planning to provide LRS wound care services can enhance their experience and optimise patient and wound outcomes by learning as much as possible in advance about patient and wound challenges they will face, the environment and policies of practice and safe, effective interventions for wound care likely to be available. This work identifies resources to inform and equip wound care professionals for successful practice to make a sustainable difference to patients with wounds in LRS. Wound care practice pearls about how to prepare and how to improve outcomes with limited resources are summarised from The World Health Organization paradigm for practice innovation in LRS. The Wound Healing and Management (WHAM) node of the Joanna Briggs Institute (JBI) collaborating with the Western Australia Centre for Evidence-Informed Health Care Practice offers Evidence Summaries for safe, effective interventions such as hydrogen peroxide, acetic acid, banana leaves or boiled potato peels that can be a vital resource for anyone considering practice in an LRS. These are supplemented with an interim summary of randomised controlled evidence supporting aloe vera and honey.

The emphasis of this paper is to discuss low-cost, self-help interventions for oedematous skin which can be utilised in low-resource communities or settings. In particular, the emerging understanding of the role of epidermal cytokines in repair, as a source of stimulating dermal oedema will be overviewed. Venous overload, due to gravitational effects, is a common contributor to lower limb oedema. A combination of epidermal cytokine activity and chronic ambulatory venous hypertension can overload a failing lymphatic system which, in the absence of overload, may not develop lymphoedema. The epidermis may switch off cytokine production when transepidermal water loss is reduced by appropriate washing and emollient application. Venous overload is helped by elevation and ankle movements, whilst breathing aids both lymphatic and venous drainage. These are low-cost self-help interventions which have been found to be helpful in resource-poor countries and can be recommended and promoted in the management of lymphoedema in a wide range of health care settings and environments.

The concepts of moist wound healing, minimising trauma to the wound bed during wear time and at dressing change and addressing wound bed preparation principles are all local strategies and considerations that can minimise wound-related pain (WRP). Such strategies include the management of moisture, infection and chronic inflammation. Despite the limited access to advanced wound care products in low-resource communities, these same principles of wound management can be used in the selection and development of wound dressing and topical wound care products in these settings. This article discusses the aetiology of WRP, management strategies associated with improving the experience of background and procedural WRP, and the efficacy of traditional wound care products in promoting pain minimisation in low-resource communities.

Lymphatic filariasis (LF) is a parasitic infection that is the leading cause of disability in the world. In Haiti, LF is considered a national disease, with many people suffering from the disfiguring and disabling effects of the disease. Eradication efforts have been under way since 1997 with projections for no new transmissions by 2020. As eradication nears, the focus has shifted to morbidity management as many patients with LF suffer from the debilitating effects of lymphoedema and hydrocele. Although there is no cure, treatment is available, leading to significant outcomes. Patients managed at the clinic in Léogâne achieved reductions in limb volume, improved skin integrity, independence with self-care, enhanced quality of life, improvements in functional abilities and activities of daily living, the ability to return to work and experienced reduced perceptions of social stigma.

Wound management principles are applicable to the management of wounds in any setting. The question is, what is achievable? I have encountered wound complexities never seen back in my normal working environment. Working with Interplast Australasia, I visited the Solomon Islands twice-yearly for eight years (between 2009 and 2016) with the aim of improving wound care within the surgical unit. Formal classroom presentations and one-on-one training was conducted in the surgical unit. I did my last tour in April 2016 as my goals had been achieved: cleanliness of the unit improved; staff had a more structured approach to performing dressing procedures and were able to implement the newly developed solutions guide effectively and there were improved healing outcomes for their patients. Modern dressings at this time have little benefit in a resource-poor setting and the solutions guide was something that is sustainable now and into the future.