Wound and vac assistance?

[Zelda21]

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

[Tenebrae, BSN, RN]

I've used negative pressure dressings on sloughy wounds

I've found if I am unable to visualize the wound edges in the case of severe undermiing AMD (antimicrobial) gauze or something similar is very good as it allows you to get it right into the corners of the wound where as the sponge is next to impossible to trim to fit a wound exactly. The gauze generally doesnt stick to the wound however if it starts granulating, you want to put down a layer of adaptic or cuticerin because trying to take gauze out of a wound that has granulated into it is traumatic and painful for the patient.

However important not to over pack the wound as you want to encourage the edges to come together.

I've found slough is not to much the problem but often lots of the wounds also have a biofilm which if not addressed will stop wound healing. As gauze needs to go in wet, I would soak my gauze in prontosan prior to packing. Once the biofilm is gone the wound should speed along.