Wound vac help!

oldiebutgoodie, RN · May 16, 2008

I would suggest you call your KCI representative and ask them to send out a consultant to help you with the first application over the skin graft.

In my area, they are pretty helpful.

Oldiebutgoodie

melissahunter2 · May 16, 2008

Thanks for the help. I did talk with a KCI representative, the only thing she suggested was an inservice. Which, we have already had.

oldiebutgoodie, RN · May 17, 2008

Thanks for the help. I did talk with a KCI representative, the only thing she suggested was an inservice. Which, we have already had.

Sorry your rep wasn't any more help. Did you check the clinical guidelines book on the KCI website?

http://www.kci1.com/Clinical_Guidelines_VAC.pdf

Page 47 has their guidelines for grafts.

Good luck,

Oldiebutgoodie

Codypatody, BSN, RN · May 19, 2008

I assume the physician placed the skin graft and the VAC immediately after surgery, correct? If so, the VAC should be in place for 3-5 days and should NOT be changed. The VAC is left on for longer in order to offload the seroma/hematoma so the graft can take. Usually, the physician will see the patient and take the VAC off to assess if the graft has taken. If they choose, they can place the VAC back on for an additional 24 - 48 hours. Did you receive any orders from the physician re: dressing changes? They usually baby the skin grafts so I would first check with the physician before changing it.

A skin graft requires a special dressing technigue. The physician will suture/staple the skin graft in place then KCI recommends a layer of non-adherent dressing be placed over the graft and suture line (ex. adaptic). The black foam is then placed on top for 3 to 5 days to offload the fluid and to allow the graft to take. The white foam can be used in place of the adaptic and black foam.

Bottom line...CALL THE PHYSICIAN FOR ORDERS! If they don't know, call KCI 800-275-4524 and talk to their Medical dept. You don't want to lose the graft. Codypatody

melissahunter2 · May 19, 2008

Thank you for your reply. This case was a mess. For some reason I had an odd feeling about this one.

blueyednurse · May 19, 2008

This is my first time on here, but once you get used to the wound vacs there's nothing to it. I do want to say though that being a first skin graft over the site, the rep. may be the one to ask questions of. Not to change the subject, but does anyone you know work for Crown Nursing and has anyone ever worked for them? :nurse:

EHRN · Jun 7, 2008

Not sure when this was posted, but maybe I can help. At our Wound Care Center, we frequently use Apligraf. If a VAC was ordered, we would place Mepitel over the graft, and depending on the amount of drainage, use either white or black granufoam. If using white foam, you may have to increase the suction. Hope this helps.