Wound and vac assistance?

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I hope some wound nurse can help me out!

I am a new grad (going on 4 months exp) working in short term rehab. I work for a level 1 tc / teaching center but our facility is off campus and due to our patient population accepted we have fewer resource than our main campus friends.

My question finally - since the entirety of the patient's wound cannot visualized, should the nurses push towards different therapy? I trust my PA's call but I just felt that since there might possible more underneath this wound if another treatment would be better.

Also, is there a good resource for wound vacs out there? I checked KCl's website but found it hard to navigate and that their education wasn't towards nursing. Thanks

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Specializes in OR, Nursing Professional Development.

You might find some information in the Wound/Ostomy/Continence Nursing forum here at AN. Also, is there a specific wound care nurse either at your facility or at the main campus that you could contact for education and/or an opinion? My facility does have several WOCN nurses who will go see patients wherever needed in the facility.

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You might find some information in the Wound/Ostomy/Continence Nursing forum here at AN. Also, is there a specific wound care nurse either at your facility or at the main campus that you could contact for education and/or an opinion? My facility does have several WOCN nurses who will go see patients wherever needed in the facility.

We are waiting on a wound team to consult her. They come Thursdays but since it'll be Thanksgiving, we will be waiting an additional week. Phoey

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It wasn't first debrided?

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Specializes in NICU.

WAY TOO MUCH detail in this post that both is irrelevant to the wound question and basically identifies the patient to anyone familiar with the situation and history. The entire paragraph above could (and should) be deleted without having any effect on the question or the responses. Can you imagine if the patient or a caretaker were trawling through this board and found this?

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Wounds with a base that are > 30% slough (that grey ick) should not have a VAC on because it's useless. That wound will have to be debrided first.

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Specializes in WOC, Hospice, Home Health.

The wound should have been debrided first. A VAC won't do much on a 100% slough wound bed. If regular granufoam is used then Santyl can be used underneath if there is some (less than 25%) necrotic tissue present. Santyl cannot be used with silver products.

If the patient is not a candidate for surgical debridement you can suggest a 7 day trial with Dakins to see if it cleans it up a bit.

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Absolutely. Admin please remove everything but my question.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
Absolutely. Admin please remove everything but my question.
Done. :)
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Absolutely. Admin please remove everything but my question.

Totally fair to remove identifiable information but unfortunately a really key bit of information was also yanked - it's a pressure ulcer, unstageable, wound base is 100% grey slough.

Wound care is a very specialized area. Don't automatically trust that your PA knows best. Unless this is his specialty, he probably doesn't. Consult with a wound clinician if you can.

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I love me a wound vac. But you want to be sure that it is going to work successfully, because they are wonderful!!

I would ask the MD about what to clean the wound with while you are waiting for the consult. And because I am that old school (or perhaps just old?! HAHA) ask if Dakens (or some other daily cleaning agent) is a possibility to try and get that wound clean.

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