Wound Vac Tips and MRSA sterile dressing

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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?

I have been using a wound vac on a patient s/p infection of a fistula placed in her thigh area. The docotor had to clean out the wound leaving behind a 11cmx15cmxup to 6cm depth. Happy to report it was almost closed completely. The docotor chose to do a small skin graft on it, since the fistula is needed for dialysis. I also closed a peri-rectal abscess area with the vac. That too went well. KCI will come out and give a inservice if its needed. The only other tip is use adhesive remover and skin prep around the site. Cut your drapes in 3, works better for a good seal.

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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

I saw a nurse the other day use a wound vac and after she put the sponges inside the wound I notice that the final sponge she pressed it down into the wound and placed the plastic on top of that then apply the suction to it. To me it seemed she was applying too much pressure on the wound. Also I noticed she place the wound vac on the bed. She also had the wound vac going continuous at 125. How do you know to do it continuous and intermittent?

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wound vacs are not indicated for infected wounds

Why not? My rep says all you have to do is change the dressing every 12 to 24 hours. And, if that is the case then why do they have silver foam? You need to call your rep and schedule an inservice. I use Vac on infected wounds all the time.

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I saw a nurse the other day use a wound vac and after she put the sponges inside the wound I notice that the final sponge she pressed it down into the wound and placed the plastic on top of that then apply the suction to it. To me it seemed she was applying too much pressure on the wound. Also I noticed she place the wound vac on the bed. She also had the wound vac going continuous at 125. How do you know to do it continuous and intermittent?

Go to http://www.kci1.com and check out their Clinical Guidelines document. That is KCI's "bible" on how to use the VAC. In general, they suggest that the first 48 hours of VAC therapy is continuous, and then switched to intermittent. However, there are a lot of situations when one might stay with continuous.

The wound vac are not positional, and can be on the floor or on a pole. If it is just sitting on the bed, obviously it can fall off and cause the hospital lots of money.

Cheers,

Oldiebutgoodie

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Go to http://www.kci1.com and check out their Clinical Guidelines document. That is KCI's "bible" on how to use the VAC. In general, they suggest that the first 48 hours of VAC therapy is continuous, and then switched to intermittent. However, there are a lot of situations when one might stay with continuous.

The wound vac are not positional, and can be on the floor or on a pole. If it is just sitting on the bed, obviously it can fall off and cause the hospital lots of money.

Cheers,

Oldiebutgoodie

It was GREAT that you gave the link to that website as I was shown by another nurse how to change the dressing and cut the foam, but after seeing the video online (at the link you provided) I noticed she had shown me a couple of things that are NOT advised! Thank you!:nurse:

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the first time i changed a wound vac i did not pre-drape the wound. big mistake. i followed the directions in the book that comes with the vac and it did not say to pre-drape but two days later another nurse with alot more experience with vacs called me in and showed me what happends when you don't drape. the skin on the edges of the wound was totaly white and eventually died. the foam had been properly sized... it is important to drape dispite what the book says. we dont use sterile technique and have never had a problem. the doctor pointed out to me that is one of the great things about vacs. everything is moving out of the wound and not going into the patients system. another thing we do, is inject alot of lidocain into the foam prior to the change and flow it over the wound as we peal the foam out of the wound. all the vacs i have worked with have been ordered for continuous but i guess that depends on the situation and the md. i have been absolutely stunned at how fast a very serious stage four heals with a vac. one day you are looking at hip bone and a few weeks later it is cover with new tissue.

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Hmm. I went to the KCI site but couldn't find any info on actually putting on a vac. i am sure there is a link or something i missed. any suggestions on where to go at the site for the video...

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The KCI website has a video, but it won't show you some of the techniques mentioned above such as draping before putting in the sponge and using lidocaine. It does stress not to have the foam any larger than the wound cavity, as if it overlaps the wound edges it will harm the intact skin. I have seen this part done incorrectly by health professionals who have not seen the video or read the instructions, to the detriment of the patient.

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Hi, I'm a home health nurse and I recently started using a KCI wound vac for a pt. with a surgical wound with 5 tunnels that wouldn't heal. The wound is on the lower back near the buttocks and we have to use a bridge in order for the vac not to block. My question is the following: How do you make your own bridge. The patient is paying for the treatment and the bridges are too expensive. I know that you can make your own bridge, but I dont know how to. If someone knows of a link that shows how to make your own bridge I would really appreciated or if you can explain how to do it, that would be good too. I would really appreciate any replies on how to make the bridge. Thank you

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You 'make' a bridge by cutting a strip of the same foam used in the wound. I've found that a strip about 1.5" wide is effective and seems to be the most comfortable for the client.

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Specializes in LTC, Med/Surg, PACU, EMT, Rehabilitation.

Making a bridge is easy, after draping the periwound area with the clear drape, then place a piece of the foam on the wound area and cover with drape. Then make sure you cut a opening at least the size of a quarter, protect the area adjacent to the wound with the drape (drape must protect any intact skin) and cut a strip of the foam to make the bridge. make sure you have the strip of foam covering the quarter size opening so that both pieces of foam will touch, then cover the strip with another piece of drape and make another opening the size of a quarter to place the track pad over that. The width of the strip you use for the bridge should be wide as the diameter of the track pad.

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