Wound Vac

Specialties Wound

Published

I have a patient that has chronic wounds on his scrotum. One of which we have just placed a wound vac on, he is obese and doesn't get up much. He is able to reposition himself which he does frequently. He is very moist in the scrotum area and they have decided to place a wound vac. And this wound vac will not stay on over eight hours so staff is replacing it every shift and it is killing his skin. Any advise on how to get the dressing to stay?

Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Any advise on how to get the dressing to stay?
Since the groin/scrotal/male genitalia region is naturally moist, the wound vac adhesive drape is not going to adhere properly regardless of what anyone does.

Alcohol-free skin prep might make his skin more likely to adhere, but not by much longer. What he really needs is a more efficacious wound treatment.

1 Votes

Have you considered ostomy paste ?? or Coloplast ??

Triad is good for wounds that can't hold a traditional dressing

Specializes in Public health program evaluation.
On 3/20/2017 at 7:10 PM, Sh4y said:

I have a patient that has chronic wounds on his scrotum. One of which we have just placed a wound vac on, he is obese and doesn't get up much. He is able to reposition himself which he does frequently. He is very moist in the scrotum area and they have decided to place a wound vac. And this wound vac will not stay on over eight hours so staff is replacing it every shift and it is killing his skin. Any advise on how to get the dressing to stay?

I haven't had a scrotal vac before, but I have had good success with using a sheet of hydrocolloid on the periwound and everywhere the skin is inflamed. It's a lot of cut and paste. Then I put the vac dressing right over top, and give a border of vac dressing around the hydrocolloid to ensure the seal. In your case, that might just increase the angry area, but the hydrocolloid is really wonderful. It will probably come off with the vac each time though. Good for angry ostomies too.

This issue of changes every 8 hours is really outrageous for a vac dressing that is meant to stay on for days. I would cancel it if I had any say in it. Without seeing this wound it's hard to say how to anchor the dressing apart from a lot more tegaderm, and getting the dressing on dry skin. If it's a question of hills and valleys, I have used ostomy paste to build up a vacuum dam before.

Once he's healed, I have had good success with using Interdry on obese patients. It's a silver-impregnated cloth that you can cut to size, and use as a wick for moisture control. It works wonders for those skin fold rashes that get out of control, and prevents candida growth. It also adds comfort to sore skin. I made a scrotal sling out of it for one male patient to good effect.

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