Wound Vac

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i have a question about wound vacs,,,i work in Home Health and we rountinely change the vac on M W F, on occasion pt goes to the MD on a tuesday and MD won't put the vac back on so we make a visit on tuesday to reapply the vac,,what is everyones opinion on the next visit being on friday vs thurs,,,with the wed and thurs being the same as sat and sun?? does that make sense to you? thanks in advance

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Specializes in Home health.

As long as the physician is applying a new dressing, the wound should be okay until Wednesday for wound vac application. You can still keep the M-W-F schedule.

Are you able to get reimbursed for visits made on the same day patient is seen by the physician?

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Specializes in OB, M/S, HH, Medical Imaging RN.

we do not get reimbursed if we see the patient the same day as their doctors appointment. i don't see a problem with the vac being off for up to 24 hours. it has never posed a problem with the wound healing.

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Specializes in Wound Care, Infusion, ER, HH.

I have worked in Home Health for a long time as a Wound Care Nurse and as long as the physician has put on a dressing (and I'm sure he/she has), it is ok to leave the wound vac off for up to 24 hours and resume your usual M W F schedule.

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That would be within the recommendations in the clinical guidelines book. It would be just like it going over the weekend.

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hi all!!! i have another wound vac question??? when cutting the black foam i was always taught to cut the foam to "fit the wound", meaning don't let and foam on the good skin, and trim it so that it fits the depth of the wound, a co-worker say she does not trim it to the depth of the wound she puts the entire depth of the sponge into the wound (example: the foam is like one inch thick, the wound is 1/4 inch thick) thanks for your help!!!

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Specializes in Home health.

Yes, the foam should be cut to fit the size of the wound. I also cut the foam to more closely match the depth but, I always place the vacuum disc over a circular full depth piece of foam as added protection against damage to the skin beneath it.

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You do not need to cut the foam to fit the wound if the surrounding skin (the periwound skin) is protected. You can do this by peridraping or covering the surrounding skin with vac drape. The easiest way to accomplish this is to put a piece of vac drape over the wound, then cut out the portion over the wound. Then put in the sponge. This method is also used for bridging (connecting more than one wound close together). Your vac rep can give you more info on this technique. The vac sponge can also be split to make it thiner using a disposable scapel or a thin version can be ordered if needed. Trust me, I teach these techniques to nurses daily as I am the hospital WOC nurse. Once again, your rep is your best resource! If you don't know who your rep is you can find out by calling KCI at 1-800-275-4524.

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The KCI nurses taught me to cut the foam slightly smaller in length, width, and depth. This helps to really suck up next to the foam but still allow room for the tissue to grow.

They also taught me to push the wound edges together with my hand, and if in a abdomen or other "fatty, squishy" area, to push in and up all the way around the wound as the suction is being turned on and holding this position until suction is comlete. This gets better coverage with the foam and brings the bottom of the wound up into better contact with the suction.

The KCI nurses told me that if I followed their instructions I would achieve faster wound healing and in my experience they were correct.

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