A.

order product through spd:

1.

SPD will contact KCI company.

2.

KCI consultants will inservice staff as needed.

B.

Dressing Application:

1.

Pre-Medicate patient prior to dressing changes.  Dressing is applied by staff RN.

2.

Two RNs will apply the dressing with the KCI consultant present when indicated.  Obtain Ostomy/Wound consults when indicated.

3.

Cleanse wound with warm normal saline.

4.

Cut sponge to fit contours of the wound.

5.

Apply skin barrier to surrounding edges of wound. 

6.

Place suction tubing across sponge.

7.

Apply transparent dressing over wound and tubing.  Pinch dressing around tubing and leave adequate margin around wound to ensure a good seal.

A leak in the seal may affect the level of negative pressure and may also allow drying of the wound.  One RN will assist by pushing down on the sponge as dressing is applied.

8.

Secure suction tubing as needed.

9.

Connect tubing to machine.

10.

For V.A.C. therapy to work, both power and therapy switches must be on.  When V.A.C. therapy is turned on, the pump display will read “Therapy On” and the transparent dressing will collapse due to the negative pressure.

The standard pressure setting is 100-125mm Hg.

11.

Never leave the V.A.C. therapy off for more than 2 hours while the dressing is in place.

If there is a loss of suction or any possibility of contamination remove the dressing and reapply as directed in the protocol.

C

Controlling Pain During Therapy:

1.

Assess and document pain at each dressing change.

Refer to reference article “Managing Wound Pain in Patients with Vacuum-Assisted Closure-Devices”

2.

Mepitel provides a cushion between wound base and VAC.

3.

Following cleansing, place Mepitel over bed of wound including edges.  Do not place on intact skin.

4.

Cover exposed tendon with Mepitel to prevent desiccation and minimize trauma to delicate tendons.

5.

VAC target settings should be decreased by 25mm/hg increments until pain is relieved (minimum 50mm/Hg).