Wound Vac Tips and MRSA sterile dressing

[garciadiego]

I'm going to be floated for a while to a floor that has about 3 patients on Wound Vacs.

I have heard that some nurses are having trouble cutting the foam, they cut incorrectely and waste a package that costs over $100.00.

I would like advice, tips, on using the Vac, like how to cut the foam, do you measure or eye ball your cut?, how to place the tubing? etc. any advice at all, so I won't be wasting material or at least I will have some idea of what to do when I get to that floor.

Also I have been told that a few of the wounds have MRSA and that the doctor has ordered sterile technique with the wound vac. dressing change.

Does It seems odd to use sterile technique for MRSA wound?

[autumleaves]

I'm going to be floated for a while to a floor that has about 3 patients on Wound Vacs.

I have heard that some nurses are having trouble cutting the foam, they cut incorrectely and waste a package that costs over $100.00.

I would like advice, tips, on using the Vac, like how to cut the foam, do you measure or eye ball your cut?, how to place the tubing? etc. any advice at all, so I won't be wasting material or at least I will have some idea of what to do when I get to that floor.

Also I have been told that a few of the wounds have MRSA and that the doctor has ordered sterile technique with the wound vac. dressing change.

Does It seems odd to use sterile technique for MRSA wound?

We have the company that supplies our wound vacs give in services. Might Look into that

[colter517]

We have the company that supplies our wound vacs give in services. Might Look into that

You could call your local KCI rep and request an in-service.

[HannasMom]

We have an inservice before we can use our wound vacs, through KCI. The foam can come in sections, which can make waste be very minimal. Wound vacs are great!

[RN1989]

Wound vacs are usually only changed every other day, unless they come off. For optimal results you will be measuring your wound (length, width, depth) and cutting your foam slightly smaller than your wound. You will assist the vac by pressing the foam into the wound slightly while putting your hands around the wound and pushing the wound edges in and up during the countdown phase of the pump - then it will suck the air out better and help with a better seal as well as bringing the wound edges into contact with the slightly smaller piece of foam.

You do not have to have the suction pad directly on the wound. If the wound is in a weird place or a small place, you can put the clear drap on skin leading to a larger place, then put foam trail down, then cover with clear drape, cut hole in drape, place suction tubing on. Example is a wound between toes. Put down your clear drape, insert foam. Cover with clear drape. Put more clear drape on the top of the foot from the toe area down to middle of foot. Cut a small hole in drape covering foam in wound. Cut a length of foam and place one end on top of foam showing through drape at wound, lay other end on top of clear drape with other end at middle of foot. Cover all this foam with clear drape. Cut small hole into drape on top of the foam that ends in the middle of the foot. Stick on suction tubing. As long as there is foam touching foam, you can stick the suction tubing to any area of the foam and it will suck the foam in the wound, even though the suction tubing is not OVER the wound. In this instance you would be squishing the toes together and pushing up on the sole of the foot beneath the toes while waiting for the suction to start to get a good seal.

My guess about a sterile instead of aseptic technique being ordered is because the docs have had a problem with someone who does not know how to do wound vacs, and or contaminated a wound that then got worse.

This is really easy once you get the hang of it but it helps to have someone show you. KCI has nurses willing to come out to show staff - they get paid to do it. There are also some other companies out now that are no longer using foam but gauze dressings. KCI of course is unhappy about this but I have seen some good stuff with the new companies vac treatments and they are much easier to use than the foam.

[oldiebutgoodie, RN]

I'm going to be floated for a while to a floor that has about 3 patients on Wound Vacs.

I have heard that some nurses are having trouble cutting the foam, they cut incorrectely and waste a package that costs over $100.00.

I would like advice, tips, on using the Vac, like how to cut the foam, do you measure or eye ball your cut?, how to place the tubing? etc. any advice at all, so I won't be wasting material or at least I will have some idea of what to do when I get to that floor.

Also I have been told that a few of the wounds have MRSA and that the doctor has ordered sterile technique with the wound vac. dressing change.

Does It seems odd to use sterile technique for MRSA wound?

In terms of measuring: I am a wound care nurse, and we have measuring sheets which are clear stiff plastic. I put the plastic over the wound and trace outline with a Sharpee. Then I cut out the pattern of the wound. Next, I take the pattern and put over the foam. Using a disposable scalpel (10-blade), I cut out the foam based on the pattern. Could also use scissors, but scalpel works FAST. The foam is now the shape of the wound. Works great.

Some people are good at eyeballing it, but I'm not one of them. Never did well in arts and crafts.

Oldiebutgoodie

[fipsez]

In my experience, cutting the foam an inappropriate size (too small) can be salvaged by adding unused pieces to fill in the gaps....just document how may pieces of foam are in the wound so they can be accounted for when the dressing is removed. Don't worry about perfection.You will get good at this over time and remember, the drape makes the entire dressing occlusive and moist so the fine edges that may be missed by the foam are still getting "moist wound care".

[BOSRNMSN, BSN, MSN]

I work on a spinal cord injury florr, and the wound vac is my BEST FRIEND. A great tool is Tegaderm, its is much better at forming a creating a seal so I start with that to seal of the sponging. Also for the sponges, I use a razor blade to cut the circle in half, and then cut thin bridges to bring the track up to the belly. (Most of my wound are sacral areas.) It is advised and probably best that the patient does not ever lie on the suction cup. For more than one wound I also create a bridge. Once you get the hang of VACS they are great. I love doing them. I usually eye ball but it is safest to measure and makes the spnges slightly smaller. Overpacking a wound with sponge and making it to tight with the suction on is very dagerous and actually creates a turnicate in the wound. Ive seen alot of tissue damage from that. But like a said Tegaderm is great. I use that for reinforcement and the provided tougher stuff is better for lying the tracks. Hope this helps. Ask me any other questions, I really do love using these VACS. I've done hundreds

[Codypatody, BSN, RN]

KCI customer service # is 800 275 4524. If you need inservicing, the customer service rep can page the local rep who services your area. Just need to tell them your zip code. The company is extremely helpful and will educate in all care settings.

[redrnr2]

wound vacs are not indicated for infected wounds

[Codypatody, BSN, RN]

Incorrect...infection is NOT a contraindication for wound VACs. One of the things a VAC does is remove infectious material. Contraindications are eschar in wound, untreated osteo, non enteric fistulas, malignancy in wound and exposed blood vessels, organs or nerves. KCI website is http://www.kci1.com

[redrnr2]

thank you, we do not have the same vac supplies in Victoria. I see that with the right dressing material the vac would be an excellent choice.