Published Sep 28, 2006
NightingaleCLNC
2 Posts
Has anyone encountered the dressing incorporating into the wound area itself? Working on a case (I am a Legal Nurse Consultant) and the dressing had incorporated itself into the underling tissue and the hardware used in a spinal instrumentation. Second surgeon was trying to revise first surgery and KCI did not have any suggestions as to what to do. What would cause this? Is it only the black dressing that would do this or would the silver also do this?Obviously it was retained somehow! Is there a recommendation for dressing count to be done per KCI or is it just protocol per each hospital or home care units? Any input appreciated Thanks!
gkrn
14 Posts
We had one incident where part of the KCI black wound packing remained in a wound but fortuantely was found the next wound change and was removed like a debridement. We never were able to figure out if the dressing tore while being removed or if a sliver of the dressing was packed at the time the bulk dressing was placed. We learned to carry a flash light and to look into the wound especially if there was a tunnel to make sure that we did not have a repeat.
There is no way to count number of dressings like sponges because the dressing is cut to fit the wound.
cookie102
262 Posts
if you put adaptive on the wound bed first the black foam will not adhere, also try cutting the foam in a snake form vs several pieces, has worked for me
nurseangel47
594 Posts
The black foam HAS to adhere to the wound bed itself to obtain adequate absorptive action of drainage. Should not be on top of any other dressing material. Should be cut, fitted to the exact dimensions of the bed of the wound iself. Otherwise, proper suction does not occur and proper drainage pull from the wound itself does not occur. Hope this helps.
Adequate visualization of the wound bed with or without assistance of additional light (i.e. flashlight), should be enough to ensure removal of all black spongey matter.
Do any of you know if a wound vac is safe to use on a draining tumor wound? Any experience or knowledge of such having been done? I have a neighbor who has had cyberknife after multiple (8) attempts to remove a tumor. He has an open wound that is draining what may be the decay of the tumor as it has shrunk by 1/3. He has gotten an infection which is being treated and now has wound care being done by home health for a week. I have never heard of a wound vac being used on such a wound and wonder if it would be good since it would potentially rob the area of O2 while draining the fluid or what other factors need to be considered.
Your input would be appreciated.
colter517
48 Posts
The black foam HAS to adhere to the wound bed itself to obtain adequate absorptive action of drainage. Should not be on top of any other dressing material.
This is absolutely untrue. The black foam may be put on top of adaptic or similar if it is a trouble to get out of a particular wound.
As far as using the V.A.C. for tumors, the V.A.C. is contraindicated for malignancy.
mrslmw
5 Posts
Hello,
I am not a nurse, but I have a question about this wound pack. My husband is in federal prison and has had a partial colon resection with a temp. colostomy for Chron's Disease. I have not yet been able to see him, surgery was 1/12/2007 but he calls and has been describing a machine that sucks stuff out of his wound and has called it a wound pack. He says his wound site is 6 cm wide by 10 cm long and is very deep. How long, normally, does it take for something this deep to heal?? He says he is finding it hard to believe this is ever going to close up and until they remove the wound pack machine I won't be able to see him.
Also, he says they only change the wound pack every 3 days. I was wondering if that sounded right.
Any input would be greatly appreciated and of course, I am not asking anyone for medical advice. I am just trying to learn a little about this wound pack machine.
Thank you!
Tweety, BSN, RN
35,420 Posts
Hello, I am not a nurse, but I have a question about this wound pack. My husband is in federal prison and has had a partial colon resection with a temp. colostomy for Chron's Disease. I have not yet been able to see him, surgery was 1/12/2007 but he calls and has been describing a machine that sucks stuff out of his wound and has called it a wound pack. He says his wound site is 6 cm wide by 10 cm long and is very deep. How long, normally, does it take for something this deep to heal?? He says he is finding it hard to believe this is ever going to close up and until they remove the wound pack machine I won't be able to see him.Also, he says they only change the wound pack every 3 days. I was wondering if that sounded right.Any input would be greatly appreciated and of course, I am not asking anyone for medical advice. I am just trying to learn a little about this wound pack machine.Thank you!
It does sound like he is one a wound vac system (not wound pack). They are indeed changed every few days. We change them where I work on Mon-Wed-Fri or Tues-Thurs-Sat.
Check out this site from a major manufacturer of wound vacs. http://www.kci1.com/35.asp
In a nut shell the vac provides continuous suction (vacuum) to help bring the bodies natural healing properties to heal the wound. How long they stay on is dependent on the size and depth of the wound, and the general condition of the patient.
fultzymom
645 Posts
We had a patient who refused to allow us to change his dressing 3x's weekly like you are supposed to (A&Ox3) and his dressing grew into his wound. The black foam was in there so badly (we even had a wound nurse consulting on his case et the doctor was aware of him refusing) that the debridment took forever to get it out of there. There should not be anything between the wound and the black foam. It is cut to the size of the wound and placed directly inside of it.
Thank you for your response Tweety!
I did check out the web link and that made it so much clearer to me.
I know he has been getting unhooked from it to walk around the floor, is it possible, or advisable, for him to be unhooked for an hour or so (so I can visit him), or does the machine need to stay connected as much as possible to do the best job?
I am not trying to push him into seeing me, I only worry that he may actually be embarrased about the colostomy bag, but that doesn't matter to me. Temporary or permanent, it doesn't change anything for me however I have read that some people get depressed or embarrased about it and I just want to be able to be there for him. At least as much as I am allowed at this time!
CoffeeRTC, BSN, RN
3,734 Posts
We have portable wound vacs. They are smaller machines and the pts can leave the room with them. For some reason I'm thinking/ remembering that if the wound vac is turned off for more than an hr the whole dressing needs changed?
Thank you for your response Tweety!I did check out the web link and that made it so much clearer to me.I know he has been getting unhooked from it to walk around the floor, is it possible, or advisable, for him to be unhooked for an hour or so (so I can visit him), or does the machine need to stay connected as much as possible to do the best job?I am not trying to push him into seeing me, I only worry that he may actually be embarrased about the colostomy bag, but that doesn't matter to me. Temporary or permanent, it doesn't change anything for me however I have read that some people get depressed or embarrased about it and I just want to be able to be there for him. At least as much as I am allowed at this time!
It is not recommended to discontinue suction. In fact treatment fails if they are off suction for more than two hours.
However, to get around this they have a rechargeable battery so people aren't chained to a plug in the wall. They can continue to recieve the suction and be off the unit and out of the room. I'm not sure how long the battery lasts but I think it's about 4 or so hours.