[bebop1]

I have a wonderful pt that has a wond vac under her left breast, that actually goes up and under her breast tissue. well I think you may need to know a little about her too. she has had a bilateral lung transplant 3 months ago...and part of the area dehised. so md placed wound vac. now I am taking care of her in home. Now at home the wound vac alarms Low suction. I called Kci and we came conclusion the vac trac pad just too close to the breast and not getting full suction. so they told me to bridge it to abd. since the wound is closing good, it was just now being pushed by the breast. so I did. two hours after I left the pt, the CG broke the suction because the vax was taking the "patients away". so next day we got orders from surgeon to put on intermittent and down to 100mmhg. she still c/o it was pulling to much, but surgeon refuses to let it be pulled off. says it maybe like a "iron lung" syndrom? pt was refusing to take pain meds because of constipation...but after I have finally talked her into it is taking the vac better? has anyone ever experience this? should I be worried? is intermittent ok? and what about it being at 100mmhg?

thanks.

[RN1989]

Sounds like this person has a lot of misconceptions/issues that are hindering care. With the significant illness/surgery she has had, the fact that the breast area is involved, refusal to take pain meds....this person needs to see a psychologist and work out these issues. It also sounds like a need for control. Most likely, nothing that you do will work as this person has deep seated psych issues related to all this stuff.

[woundcarespecialist]

It seems that KCI has everyone brainwashed that their system is the only one available for NPWT. There are several out there that uses pressures as low as 80 and utilizes amd guaze rather than a hunk of scotch brite. Maybe a dressing with less mass and pressure would work?

[pressurefree]

Talk with kci again and they can let you know that if a pt is having increase in pain that you can decrease the pressure and yes it is ok to use intermittent pressure. This will also help with the pain issue. An instead of bridging it across the abdomen try doing it down the side if possible.