I am terrible at eyeballing when it comes to cutting black foam for a wound VAC! I have never tried making a template or anything but I might next time! My question is: What do you do if you cut the black foam and put it in the wound bed and then need to cut more foam off? The foam has already touched the wound bed. I don't like putting the foam in, removing it and cutting more foam and putting it back, on and on. However,iIs it OK to do this? It probably isn't optimal but the wound has been cleansed. I can't see another way around it other than starting over with a new piece of black foam every time!!..which would be very wasteful! Thoughts...
Apr 3, '11
I usually take the plastic package from the foam dressing, place the steril side of the package over the wound, and then draw the pattern. I have seen surgeons place the black foam into the wound, remove it, cut it some more, and then place it back in. I think that may be okay, as long as you didn't set it down on anything. It's the same bacteria that you are placing back in the wound. I'll be watching for other opinions on this topic.
Apr 14, '11
Just had visit from our V.A.C. rep yesterday,good to get refreshers/updates/tips! You can cut more than one piece of foam for a wound, if you're not good at eyeballing the shape. Better to have 2 pieces that fit,rather than in/out, or worse-too big. ALWAYS document # in/# out in EMR, also note on drape number of pieces in. Supported in "Clinical Guidelines"-Reference source for clinicians-KCE 08/10.
May 2, '11
I have removed the foam and trimmed it. Just be sure to do this away from the wound so that there are no particles of granufoam landing in the wound base. Wound VAC dressing changes are never typically sterile unless we do them in the OR. I do like to wear sterile gloves for most VAC dressings though.
Sep 12, '11
Just as long your foam, field and techniques are sterile, put in and taking out the black foam is fine. Like what Shermbrn suggested, to draw the template out with the plastic cover after dropping your black foam on your sterile dressing pack. It is advisable to do that. It is better to be smaller because you can still stuff in smaller pieces. IMHO.
Mar 12, '12
I just took a KCI VAC class on Friday. The instructor suggested cutting the entire sponge into a spiral so it would look like a cinnamon roll, then unrolling it, and placing it into the wound bed starting from the edges and working in a circular pattern until the bed is covered. When the wound bed is full you then place the drape. I like to cut my drape into strips because it's much easier for me to work with several small strips than one big piece. Hope this helps!
Mar 21, '12
Everything you are doing is ok! It is not necessary to get a brand new piece if you were to remove the original. Just make sure you aren't touching anything else except the scissors in one hand and the dressing in the other!
I like the "cinnamon roll" technique the previous poster described. I have used that with great success.
Here is a great article clarifying clean vs. sterile and when it is optimal. http://www.wocn.org/resource/resmgr/...ressing_te.pdf
Jun 28, '12
I like the idea of making a template with the sterile side of the wrapper. Right now I cut more than one piece because I cannot eyeball the size for the life of me!!
Jul 24, '12
Cutting in to a spiral is an awesome way to get a good fill without having to remove and replace to resize the foam. Also, you can bridge the foam away from the wound if necessary (making sure there is protective drape under the bridge unless you are using a specific bridge piece foam). And remember to cut pieces away from the wound and dressing site to prevent tiny foam pieces or flakes from falling into the wound or on the drape. Lastly, always document the number of pieces you used in the wound.
KCI offers online videos and education for free for their wound VAC applications and dressings. Go to www.kci1.com
and click the education tab.
Best of luck!
Aug 26, '12
We don't use KCI that often in our clinic, as our doc prefers a different company but I am going to try using the spiral cut next time that is a great idea.
Aug 31, '12
Anyone have experience with scrotal wounds? I have a patient with a sizeable (4x3x0) anterior scrotal wound with significant slough, induration to the "west" of that wound with tiny areas of oozing and slough and a perineal area near a gluteal fold that is raised, indurated and opens and closes with exudative purulence. I have not received any diagnoses other than ulcer. I believe there is something more going on. Thanks for any insite.
Sep 5, '12
Its so much easier using gauze based systems for Topical Negative Pressure, no cutting, gauze fills the cavity, its great for sinus' and works at much lower pressures (80mmHg) which patients find more comfortable & to be honest I think it gives better results without granulation tissue embedding in the foam
Sep 5, '12
Is the patient taking Nicorandil (Ikorel) for angina? Ive dealt with a few caused by it they can be difficult & need monitored closely incase there is fistula formation to the bowel