When to stop wound vac

[nurseguy213, LVN]

Wound opened on the back, parallel above the waist after staples removed. It was less than .5cm deep and 7cm and 3cm at the widest. After 3 weeks it's now closed and filled with granulation, no drainage, just hairline opening where the edges have not closed or filled. Should vac be stopped now? Change to daily dressing change with triple atb or continue vac til completely closed?

[mommy.19, MSN, RN, APRN]

Usually vac's are d/c'd after drainage is controlled or depth of the wound is resolved. This all depends on the original intent or goal of the NPWT, however.

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[Mem29]

Wound opened on the back, parallel above the waist after staples removed. It was less than .5cm deep and 7cm and 3cm at the widest. After 3 weeks it's now closed and filled with granulation, no drainage, just hairline opening where the edges have not closed or filled. Should vac be stopped now? Change to daily dressing change with triple atb or continue vac til completely closed?

This less then the depth that Medicare standards have for use of the vac. I would stop this now. The goal of the vac is finished. It may actually keep it open if the foam is still having to touch the skin.Personally, I really hate the abx ointments. This greasy substance under a dressing easily leads to hyper granulation tissue. This is tissue that grows up above the skin line and will not allow it to close. The best thing is a wound gel (no petrolatum). This will keep it moist and let it finish healing. Can be used 1-2 times daily. Or if it is that shallow can it be steristripped, pulled together and left alone? Sounds weird but I do it all of the time and the wound closes well and less attention or nurse hours need to be spent doing this.