I'm hoping for some help in finding some tips of using a KCI portable VAC on wounds that have undermining/tunneling. My husband has a wound care specialist, a KCI nurse-rep and his regular visiting nurse dealing with his care. In two weeks, he's had many low-pressure and blockage alerts due to leaks near the tubes/drape. Tho', we never get a leakage alert, which would help because then I could access the leak detect system. He's already on a second machine, in the hopes that it would work better (only, slightly).
The wounds were caused by a tummy flap opening up at two suture lines and the undermining has created a tunnel leading from a larger wound (11.5 cm x 7.5 cm x 1 .5 cm deep) near his chest to a smaller wound (2.5-3 cm diameter x 4-5 cm deep) which is near the bottom of his abdomen. There is a tunnel that connects the two. It's kind of like a skin bridge between the two, right down his middle. On this "skin bridge" is another hole (2 cm x 1 cm) that resulted from the suture line breaking down. At the big wound, there is more undermining around it - At 1 o'clock: 3-4 cm; 8 o'clock: 8-9 cm and 11 o'clock: 3-4 cm, just under the skin's surface. BTW, he's not Diabetic. The wound looks good. There's no infection or foul smell.
The nurses are all having trouble getting consistent 125 suction in this wound. They're using white foam with a y-connector with one tube going to the large and the small wound, each. We've finally achieved a 48 hour wear time by this morning but there were many alarms and audible leaks from the small wound's tube/drape during that time. I tried to fix it with tagaderm and extra pieces of drape. It would work for a few hours (Phew), then the alarms would start going off again (ARGH!). Normally, I would take it off but we wanted to see if fixing the drape would help.
He's not very active. He stays in bed, so we have no clue as to why he keeps getting leaks. The vac's pressure would go to zero, then climb up to 175
, settle at 100 for a few minutes, then go back to 125. Even when he's laying perfectly still. No one can tell me why.
His nurses have spoken about having two machines to help keep the pressure consistent at 125. Has anyone heard of doing this before? Is this safe? Is there anything *I* can do to help this vac last longer and stay consistent? Is putting on more than one drape necessary? Does foam need to be placed into the undermining? Is there anything I can do with the tubes? Right now, they only cut the foam to be large enough to fit about 1cm all around, underneath the large wound opening. For the small wound, they loosely put a strip of cut foam and curl it (Like a piggy tail) and make sure it touches the strip of foam under the "skin bridge" to make sure everything is holding hands. Then they top it w/ another piece of foam, drape it and add another piece on top. Is this enough? Should the undermining/tunneling have more foam in it?
I understand if you can't answer my question but I thought this would be a good place to try. Thank you for any assistance!