Wound vac question/vent - page 3

I'm a new grad with very little experience with wounds, so I have a situation that confuses me. Am I just experiencing newbie jitters or am I legitimately concerned? The nurse orienting me told me... Read More

  1. by   jadelpn
    Seems like there's a couple of things going on. IF one has a closed surgical wound, and no infection present, then I could see how a wound vac could promote healing over sutures. Brings the edges together, that type of thing. Great idea.

    What you seem to be describing, OP, is an infected wound, that I would think the wound vac needs to be used in an alternate way. The sponge actually has to be fitted INTO the wound for it to do anything. Even more so, by encouraging the closing of the surgical site, ya'll will be back at square one when the wound closes, and the infection is still present and is damaging to the underlayers of the skin. I would worry sepsis in that instance.

    Osteo in my experience (and this is not medical advice per TOS, just some thoughts) is mostly controlled/cured with Vancomycin. And most usually IV. Sometimes with an alternate antibiotic as well, such as rocephin, again, IV. Even though the patient is on oral antibiotics, it couldn't hurt to get another culture, and see at this point what it is growing. And I would advocate that because of the immense amount of drainage, that the sutures are removed, that you use the vac inside of the wound, and an alternate course of IV antibiotic treatment. With a wound vac, the wound heals "up"...in other words, it heals from he base of the wound to the outside of the wound. Therefore, to be able to get the sponge down into the wound would be helpful to this patient.

    Wound vacs are highly billed money makers for a facility. So that now they are being used to promote a healthy surgical site to heal better doesn't surprise me. What does surprise me is that the MD is not aggressively treating this patient's infection, as well as her wound in such a way that it will actually heal, once the infection is addressed.

    What you could also do, is advocate for the patient to be seen at a wound care center. When there are complex wounds with infection, wound care MD's and nurses are amazing at what they do. And they can point you all to a treatment plan that will be to the patient's function and benefit.

    Let us know how it goes!