I wasn't inserviced by the KCI rep, but another nurse that was. I don't think she is doing it right.
She put a tegaderm directly over the wound, then the sponge, then the drain part, followed by another tegaderm? How the heck is the drainage supposed to get thru the tegaderm?
Shouldn't it be the black foan cut to size, then the drain/suction tubing, then a tegaderm?
The last time I did one, the sponge went directly onto the wound...I believe there was one once that I did that had orders to put gauze and then the sponge on the wound. You are right though, if there is a Tegaderm over the wound it will contain any drainage that the wound vac is supposed to draining. It should be the sponge, the tubing and then there are clear, plastic dressings, like Tegaderm but, made by KCI that go over the whole thing, to create a seal...they are usually much bigger than a Tegaderm.
Last edit by Lisky90 on May 29, '07
: Reason: Didn't finish answering the question
THE BULK OF MY WORK AS A HOME HEALTH CARE NURSE IS WOUND CARE. I TRAINED WITH THE KCI REP AND DID FOLLOWUP TRAINING WITH OUR AGENCY WND CARE SPECIALIST RN, AND HAVE SINCE DONE MANY, MANY WOUND VAC TREATMENTS, AS WELL AS ASSISTING IN TRAINING OTHER NURSES IN THE TECHNIQUE. WHAT MAY HAVE HAPPENED WITH THE USE OF TRANSPARENT DRESSING (TEGADERM) SUPPLIED WITH THE KIT IS THAT THE TRANS DSG WAS INDEED APPLIED OVER THE WOUND, USUALLY WITH THE AID OF SKIN PREP AROUND THE WOUND SITE. THE TRANSPARENT DRESSING IS THEN CUT AWAY FROM THE WOUND ITSELF, FOLLOWING THE WOUND EDGES, BUT LEAVING SURROUNDING SKIN PROTECTED. WE USE SMALL SCISSORS WITH AN UPCURVED BOTTOM SO THAT THE PATIENT IS NOT INJURED CUTTING AWAY THE TRANS DSG. AFTER THAT A NUMBER OF OF OPTIONS ARE USED, DEPENDING ON WHAT IS APPROPRIATE FOR THE PATIENT. ADAPTIK OR WHITE FOAM MAY BE USED TO PROTECT THE WOUND BED, THOUGH WE OFTEN TRY BLACK FOAM ALONE INITIALLY. THE FOAM SHOULD TOUCH THE WOUND ONLY, NEVER HEALTHY TISSUE, AS DOING SO DAMAGES THE HEALTHY TISSUE. AFTER THE FOAM IS CUT TO WOUND SIZE AND APPLIED, IT MUST BE COVERED WELL WITH ANOTHER LAYER OF TRANSPARENT DRESSING WHICH COMPLETELY COVERS THE FOAM AND EXTENDS BEYOND THE FOAM, ADHEREING SMOOTHLY AS POSSIBLY TO ENSURE A GOOD SEAL. A HOLE IS THEN CUT, ABOUT THE SIZE OF A NICKEL. THE ADHESIVE IS REMOVED FROM THE BOTTOM OF THE WAFER WITH THE DRAIN ATTACHED AND PLACE OVER THE HOLE. I FURTHER SECURE THE WAFER WITH A BIT MORE TRANSPARENT DRESSING. THIS HELPS ENSURE IT ISN'T PULLED OFF WITH THE PATIENT'S MOVEMENT. OK, THAT'S KCI. WE ALSO USE SMITH AND NEPHEW AT TIMES, WHICH REQUIRES A DIFFERENT TECHNIQUE REQUIRING LESS TRANSPARENT DRESSING, AND USUALLY, BUT NOT ALWAYS, GAUZE INSTEAD OF FOAM. WOUND VACS SHOULD BE CHANGED EVERY OTHER DAY, THOUGH IT IS USUALLY ACCEPTABLE TO SKIP 2 DAYS A WEEK, AS ON THE WEEK END. I DEAL WITH MANY WOUND CARE MD'S AND ARNP'S AND DONT BELIEVE THIS HAS EVER BEEN UNACCEPTABLE TO ANY OF THEM.
Last edit by dogmacatma on Sep 5, '10
: Reason: ADD ANSWER TO QUESTION