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Wound Vac
Open Dropdown
Preoperative Considerations
Consent:
- Mobility difficulty
- Skin irritation
- Bleeding
Anesthesia/Positioning:
- None
Other:
- Ensure home wound vac coverage prior to initiation of wound vac therapy, or patient will need to remain inpatient until wound vac is no longer required
- Gross wound contamination is a contraindication to wound vac placement
- Be conscientious when placing lily pad adaptor. Wound vac suction line should be oriented in a direction that allows for patient mobility and comfort.
Armamentarium:
- Wound vac machine
- Wound vac sponge (black, white)
- Wound Vac Film (Dressing)
- Lily Pad (tubing from patient to machine)
- Mastisol
- Heavy Scissor
Technique
- Black sponge is cut to size and shape of wound
- Sponge can be pressed to wound to leave a marking the guides trimming
- Clear wound vac dressing is then cut to size and applied according to directions on packaging
- Clear dressing should not be placed circumferentially around an extremity due to risk of compartment syndrome
- A hole is then cut through the dressing over the center of the sponge to allow for placement of the "lily pad" adaptor
- Lily pad adaptor is placed directly over hole
- If performed in sterile setting, wound vac line is then passed off the field to circulating RN where it is then connected to wound vac unit
- Once wound vac unit is powered on, a seal check will begin and negative pressure will be applied
- Wound vac unit will indicate that seal is achieved, or will alarm if a leak is detected
- Once seal is achieved, wound vac unit will continue to deliver negative pressure as programmed
- 120mmHg, continuous is the default and most common setting on most wound vac units
Postoperative Considerations
Immediate:
- Can reinforce seal with tegaderms
- Stoma paste can be used to plug small leaks
- If available, hospital wound care team is often very helpful for difficult wound vac placements and troubleshooting
Follow Up:
- Wound vac changes are typically needed every 2-3 days depending on location and rate of healing
Operative Note
Coding
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