miss_mary

I've had a wound vac for two weeks now, for a dehisced abdominal incision. Originally, I was seeing a wound care nurse that I was referred to by my surgeon, and I was very happy with the care I was getting, and I trusted her level of expertise. Unfortunately, after the first two dressing changes, she had a family emergency and can no longer do my care. So my surgeon sent me to a wound care clinic, in another nearby hospital. There are 3 wound care specialists there, and now all three have done one dressing change each, but they all consult with each other, and assist as available. I don't think they are doing it as well as my original nurse. The machine now continuously gurgles, and they just don't seem to able to get the dressing sealed down right. They've said they are not familiar with my particular machine (the portable one), and it doesn't seem like they are all that familiar with the VAC in general. I've been doing a lot of reading about the wound VAC (here as well as other places), and I wonder about a couple of things they are doing. For one, they cut the foam so that it is sticking out of the wound by a half inch or so, then put another piece on top of that, then the drape and the port. For another thing, today, the foam was sticking out like two inches, so the nurse took a pair of scissors and cut the foam right there, while it was already in the wound. She cut it down until it stuck out about half an inch, and put another piece on as before. Isn't that a no-no, as little foam bits could get into my wound? This is not how my other nurse did it. She would very carefully cut the foam to the right size, place it in the wound flush, then do the drape and port. The are also putting a colloid dressing material on my skin surrounding wound, underneath the drape. My other nurse didn't do this either. So, are they doing it right? And if not, how do I handle getting them to change their procedure? I don't want to be a jerk, but I also don't want to put up with having my care be less than ideal.