Please Help

[ks_cop_nurse]

I work in a nursing home i have a resident that has 2 stage 4 wounds in the lower ext. The wound vac that i was taught to use is like this. I wrap gauze like material around a small suctioning tube with small small holes in the tube pack it in the wound and connect to canister, secure the wound with alkare and tegaderm. The tegaderm will not stay secure do to all the drainage from the wound. Secured with tegaderm and mefix today and 2 hours later the wound drained onto the floor. There has to be a better way to secure this wound, keep in mind we have a cheap company LOL. This is suppose to be changed every 3 days and im lucky if it stays on 12 hours. Please help me to mindstorm on how to keep the dressing on longer and without leaking every where. The resident is in the 40-50;s age and very very obese. Any thought would help THANKS

[sharlynn]

Where's the foam? Is this a real Wound Vac or someone trying to make do with just a suction machine and dressings available? And I thought my place was cheap!

[pugluvr1]

This does not sound like any VAC from KCI...if your patient has two Stage 4 wounds and sounds like excessive drainage you may want to consider them to be evaluated in the hospital first. They need to have wound status evaluated, make sure no infection, then plan of care would address needs of patient. When you have excess drainage you have to look at how to control it and wick it away from intact skin....your vac system does NOT sound adequate to start with. First take care of infection if there is one, which will decrease the amount of drainage. then get a real vac system from KCI,,,if this is not an option then stop that suction set - up and use skin barrier wipes around wounds to intact skin,,,,,then fill the dead space (pack the wound) with a dressing that holds more than its weight in exudate (drainage)...such as foam dressings or aglinates,,,,if there is any tenneling or undermining you will need to pack these areas with kerlex to help wick exudate out of those tunnels....ABD's on top is cheap alternative....change 3-4 times a day....if you are close to Wichita area there are several good wound care docs...hope this at least gets you some relief,,,,

[ljnvb]

The vac that she is describing is a real wound vac. It is called the wasp. Just done by another company and you do not have to use foam. What you need is to use stoma past around the areas. Also you do not wrap the wasp tubing with dressing. You need to take the guaze dressing apply silver nitrate paste. Then you take the guaze with a Q-tip and layer the guaze in the wound. Packing lightly into areas that are tunneling. We are using this system now and have found that it is remarkable. It works just as good as the other companies vac but for half the cost. The original company cost is about $5000.00 per month. This vac costs less than $2000.00 per month

I do have to agree that you need to make sure that there is not an infection.