We are trying a new wound vac company

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    We have been using KCI wound vacs for the past several years. Last week we got a new resident on our rehab unit directly from the wound clinic. We knew he was coming with a would vac from a different company. The company is called Blue Sky or Sky Blue! It is the same principal, but I'm not sure it works as well. They use Tegaderm and another product from Medline ( which is suppose to be cheaper). The pump is not as complicated as KCI. I placed the vac on with the reps from Blue Sky originally last friday. It happens to be 3 foot ulcers. One on the sole of his foot and 2 over the mallolus and they need to be bridged. We had to moisten a gauze impermeated with an antibacterial.There is a long tube that has a flat end with many holes in it. The gauze gets wrapped around this and then a strip of stomahesive is used to keep the tegaderm sealed. The other end of the tube goes to the pump! I feel like it is so much more time consuming than the KCI, ( too many steps). Then yesterday, I changed the vac again ( he went to the wound clinic also this week), I found the wound to be macerated and very pale looking. The Dr didn't seem to be concerned.
    My question is, have any of you used this product? and how do you think it compares to KCI?
    Believe me, if somehing is cheaper and works, I'm all for saving money, especially when it comes out of my tax dollar!
    Your input will be appreciated!

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  2. 12 Comments...

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    The hospital I work for wants us to use the Blue Sky NPWT as opposed to KCI, thinking it will save money. It is changed twice a week instead of three times a week for the KCI. Personally, I think it works okay for wounds on the abdomen, but I don't like to use it on Sacral wounds because of the tubing. I have gotten into the habit of putting either foam or hydrocolloid under the tubing to prevent the patient from developing a pressure ulcer caused by the tubing. I think when you factor the cost of those products into the dressing change, then the hospital isn't saving as much as Blue Sky claims.
    gettingupthere likes this.
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    I've seen the literature and it looks good. The rep that I received an inservice from used to be a rep from KCI. The problem with the Blue Sky is that they recommend a suction level that is too low. But the FDA has mandated that they only say to use the product at 70-80 mm hg. The wound care doc and this experienced rep recommending going against Blue Sky's mandated recommendations and use the 120 that the KCI vac uses. They state that you can get the same results as the KCI vac if you use the higher suction.

    There is a big "to do" over the newer wound vac companies as KCI does not want competition. They have tried to keep it out of the news so that they don't look like the bad guy. It isn't pretty - that's one of the reasons for the problem with getting info about these newer companies.
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    I have seen the Blue Sky system once in home care. I like KCI's system better. I only had the one patient on it, but it seemed as though his wound did not heal as fast. I think KCI's system is easier to use, too.
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    I work at a large teaching facility. We use KCI. We had tried out Blue Sky, but no service in the hospital was happy with the results. Now we have gone back to using nothing but KCI.
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    Our facility totally went BlueSky a few weeks ago. A rep from the company came in and replaced all the KCI vacs with the Bluesky. Our unit only had one, it was on a sacral ulcer that a resident got at the hospital and further progressed ( resident doesn't eat, refuses to get out of bed, will only lay on one side). The next day I came in and the vac had slid up her back, so we redid the whole thing, the next day the same thing happened, this happened 4 days in a row! ( So much for saving money). The lady fell out of bed early the next morning and went to the hospital. When she came back 2 days later, she had a KCI on and we were told by the wound clinic that we were NOT to use Bluesky on this lady! So now I believe they are rethinking the whole Bluesky thing! It has WAY too many steps, much too time consuming, especially if it needs to be redone every day!
    PS, it has been 4 days and the wound looks much better, still a long way to go, but a definite improvement!
    I felt like when we had our 1st pt using it and we didn't like it and felt that it was using too much nursing time and the wound didn't heal as fast, that administration should have listened to the nurses!
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    All that literature you see about their product are the case studies done by KCI. Read the fine print. They have very little literature about that drainage containment system, which by using gauze is all that it really is. You can't get the microdeformation with gauze. The secret is in the foam. And if you think about it, if gauze under suctions works then why haven't we been hooking people up to wall suction with gauze?

    There are independent studies out there (some in previous editions of Wounds magazine) that compare Blue Sky and KCI. The results were not favorable for Blue Sky. KCI's system is much easier to use and you get great results. Also, a product is not cheaper if you have to use it twice as long. Plus their dressings can get expensive, with KCI you pay a price for a certain size, with the gauze you pay per package of gauze and if you have a whopper of wound it will surpass KCI in daily cost.
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    Blue sky always gave me fits. KCI still best IMO.
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    As a nurse in a LTC facility we have used that vac also it did not fair well with us. We now have a contract with a company that uses the Medella Wound vac it use a thin sheath called dermanet that goes directly on the wound bed and then you add a moistened gauze over that then you cut the tubing and place it on the wet gauze then apply a dry dressing and then a piece of opsite. I do believe it is much cheaper than the kci but not sure if cheaper than the blue sky.
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    the secret is in the foam. and if you think about it, if gauze under suctions works then why haven't we been hooking people up to wall suction with gauze?

    this is exactly where this type of negative pressure therapy began. doc's thinking out of the box applying saline saturated gauze and applying suction via wall suction.

    there are independent studies out there (some in previous editions of wounds magazine) that compare blue sky and kci. the results were not favorable for blue sky.

    ostomy/wound management - issn: 0889-5899 - volume 51 - issue 3 - march 2005 - pages: 44 - 49

    negative pressure wound therapy: “a rose by any other name”

    - michael s. miller, do, facos, cws; chris a. lowery, ma, do
    subsequently in 1987, usopov and yepifanov<sup>9</sup> published their findings regarding the effects of wound drainage after surgical intervention. until this time, no uniform opinions were available regarding when to use vacuum therapy, what the duration of the therapy should be, or what amount of negative pressure would be most beneficial. using wounds created in a rabbit model, the authors applied varying levels of negative pressure along with passive drainage as a control in an attempt to study the effects of active wound drainage in a clinical setting. the authors determined that a pressure of -75 mm hg to -80 mm hg had the most distinct effect on increasing wound drainage with little or no hemorrhage of coagulated vessels. as the pressure increased to -120 mm hg to -125 mm hg, extensive tissue edema was observed with separation of the adjacent muscle fibers secondary to the edema....complication rates for all patients then were compared. the authors concluded that to avoid tissue damage negative pressure in active drainage systems should not exceed -80 mm hg; lower pressures were less likely to demonstrate postoperative hemorrhage.

    kci's system is much easier to use and you get great results. also, a product is not cheaper if you have to use it twice as long. plus their dressings can get expensive, with kci you pay a price for a certain size, with the gauze you pay per package of gauze and if you have a whopper of wound it will surpass kci in daily cost.[/quote]

    if you call paying 2 to 3 times a day more in rental fees and multiples more for dressing sets cost containment you need to step away from the cool aid. i'm not saying kci system is horrible or ineffective, but don't close your eyes to other options and allow their untainted results to weigh on their own merits. i have to say a roll of kerlix amd has to cost less than a very large dressing set from kci.

    ask your kci rep if you can disconect the patient from the therapy and crimp the suction line to the wound and allow the patient to disconect for an hour or so without re-dressing the entire wound?

    do your research...of course kci the only game in town for many years has tons more studies, but don't discount another therapy option that has it roots well before the founder of kci made his first bed in his apartment.

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