I work in a sub acute unit and we have a wound care nurse who visits and gives new orders once a week. I have a pt who had a substantially large wound and she has continuos problems with the vac beeping and the dressing losing suction pressure. I have asked the cnas and therapist to please be careful when caring for and dressing her. Any ideas what can cause this or how I can improve the dressing stating intact? The charge nurse changed the dressing yesterday and 1 hr later I had problems and no drainage???
Aug 9, '12
Where is the wound? iIf the wound was dressed prone and she is moving and there is a now a big crease on the dressing it may be causing the loss of suction. If the location of the air leak can be found reinforce it with a opsite or a tegaderm.
Also there should be a number on the machine that you can call to trouble shoot the problems.
Aug 9, '12
The wound was the result of AC from hip fracture that got infected and the pt developed mrsa . The surgeon had to debride it because the infection was down from the top of the hip to the knee. We had retention sutures to start with partial wound open. After several months the wound is about 14 in in length and 8 inches deep with the trochanter visible. She is a very large woman and it is left lateral hip. It is a constant problem and it takes 20+ minutes to just pack/ dress. Then I have constant issues because in am I switch her from a lg vac down to a sm portable vac which she insists on for therapy even the the nurses feel it is unable to keep up with the wound. So- all clamps open tubing clear suction @ 125 and it will beep and say tubing blocked or can muster full and the pressure will fluctuate. I am frustrated because it is a continuous problem for staff and pt but noone is taking the time to solve the issue it is just temporary fixes!!! I have stressed to the pt cnas and pt to please not pull on tube when dressing ( the pt wants it a particular way and I have tried to secure the tubing with sx tape to anchor it si that it doesn't weaken the dressing seal but she has refused to let me do it staring the tape irritates her! Which now once again without doing this there is a problem . I'm do frustrated and I appreciate the input!
Aug 18, '12
I suggest windowing the wound with duoderm. The drape adheres better and creates a more secure seal. Also, sometimes if the VAC is alarming the canister may be full.
Sep 23, '12
Thanks. I have had great results. I have recently learned to work with the wound vacs and I have had success because of the input.
I truly appreciate the help.
Sep 27, '12
sometimes too, other than putting the drape down first, if you have areas that still are not sealing, use some adaptic paste( the type used for ostomies) to seal some of the holes. I had to do that with people that have had wounds in the natal cleft. Also draping the wound keeps the sponge off of the good skin( a good thing)