WOUND BLOG by Matthew Livingston RN

Trouble Shooting

Titrate pressure settings > 25mmHg

Large drainage volume

Large wound size

Titrate pressure settings < 25mmHg

Inability to control pain regardless of appropriate analgesia

Excessive bruising

Patients with malnutrition

Patients with compromised circulation

Trouble Shooting

1. Check the screen on the pump for a clue to problem

2. Check seal to make sure it is intact

3. Check clamps

4. Check canister to see if full

5. check tubing for debris.

6. Consider changing the canniest or pump

If Unable to resolve the Problem

1. Call for or change the dressing order.

2. Place saline gauze short term until the wound can be evaluated and therapy restarted.

3. The VAC is not to be turned off with the foam intact for more then two hours in a 24 hour period.

Tips to assist VAC placement:

A. For smaller wounds surround the wound edges with a hydrocolloid or VAC drape

to reduce the risk of foam suction trauma on normal tissue

B. Stoma paste is useful for the filling in difficult contours or skin folds so the drape can sit over a flatter surface, and maintain a seal

C. Cover and protect weakened, irradiated or sutured blood vessels or organs with Mepitel

D. Contract larger wounds by cutting the foam smaller than the wound. Then, after securing the drape to one side of the wound edge, pull the drape overthe foam. At the same time push (with care) the undraped wound edge towards the wound bed and sponge. Finally, lay the drape down on the undraped side a few cm at a time while slowly moving the tension providing hand out from under the drape.

If the wound has clinical signs of infections consider:

A. Consider the V.A.C. Instill with Dermacyn irrigation

B. Use Acticoat 3 for small to medium sized wounds with a uniform wound bed.

C. If the above therapies are unavailable change the dressing every 12 to 24 hours.

Recommended VAC Therapy Settings

Continuous -125 mmHg

Acute Traumatic

Partial-thickness burns Pressure ulcers

Dehisced wounds complex abdominal wounds

Continuous -75 to -125 mmHg

Meshed graft

Bioengineered tissues

Continuous -50 to -125 mmHg

Diabetic foot ulcers

Chronic wounds

Continuous -125 to -150 mmHg

Flaps