How to Use a Wound Vacuum

Approximately $10 billion is spent each year on chronic wound care, according to research done at Ohio State University. These wounds may occur as the result of diabetes, ulcers or trauma. A wound vacuum, or vacuum assisted closure machine, is a device that is used to treat chronic, difficult-to-heal wounds. A foam dressing is placed in the wound and subjected to negative pressure. The pressure draws excess fluid out of the wound and increases blood flow to the wound to promote healing. The treatment process involves delicate dressing changes and must be performed by a qualified health care professional.

Things You'll Need

• Disposable gloves
• Sterile gloves
• Sterile gauze
• Sterile normal saline
• 30-60 ml syringe
• 16-18 gauge needle
• Wound V.A.C. foam dressing kit
• Wound V.A.C. drainage canister
• Wound V.A.C. machine
• Sterile scissors

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Instructions

• 1

  Confirm all orders for treatment with the supervising physician. This includes the orders for the administration of medications. Pre-medication should be performed thirty minutes prior to the start of the treatment to decrease the discomfort the patient experiences.

• 2

  Place the V.A.C. machine on a flat level surface near the patient. Gather all the supplies needed for the procedure. Place them in the order of use for a smooth transition between steps.

• 3

  Wash your hands thoroughly with soap and hot water. Don a pair of non-sterile gloves.

• 4

  Explain the procedure to the patient using terminology they can easily understand. This will put the patient at ease.

• 5

  Remove the existing dressing. Work slowly and carefully to avoid disturbing the wound. Inspect the dressing. The presence of a green or yellow drainage indicates an infection may be present. If the dressing is soaked with blood, more frequent dressing changes may be necessary. Dispose of the dressing in the appropriate bio-waste receptacle.

• 6

  Inspect the wound. The presence of pain, a foul odor, redness, or swelling may indicate an infection is present in the wound. Measure the length, width and depth of the wound. Document the condition of the wound bed and the size of the wound. You will compare these findings after each dressing change to gauge the effectiveness of the V.A.C. treatment.

• 7

  Clip any hair that surrounds the area of the wound. Clean and dry the area surrounding the wound with saline and sterile gauze. Irrigate the wound with sterile saline solution.

• 8

  Remove soiled gloves and wash your hands. Place the V.A.C dressing kit on a flat surface. Open the kit and remove the sterile gloves package. The cuff of the gloves will be folded upward. Lift the gloves touching this portion only. Put on the gloves. Do not touch the outside surface of the gloves.

• 9

  Cut the foam dressing to match the approximate size and shape of the wound. The dressing should fill the wound without overlapping onto the intact skin. Do not cut the dressing over the wound because stray pieces may fall off the edges of the dressing and into the wound.

• 10

  Place the foam into the wound. Several small pieces of foam may be used to fill the wound cavity but all of the pieces must remain in contact with each other. Do not place foam portions into unexplored wound tunnels.

• 11

  Trim the transparent drape so that it extends three to five centimeters past the wound in all directions. This dressing needs to provide an occlusive seal in order for the vacuum to work properly. When in place, the drape should not compress the underlying foam. Several pieces of the transparent drape can be used to cover an area as long as you are able to form an airtight seal. Lift the drape and cut a two centimeter round hole in the center. The hole must be round, as a linear slit can collapse under the negative pressure of the V.A.C. machine.

• 12

  Remove the backing from the T.R.A.C. pad. Place the center of the pad on top of the center hole you cut in the drape. Gently press on the edges of the pad to fully adhere the pad to the drape. You may add more transparent tape as needed.

• 13

  Remove the drainage canister from the packaging and insert it into the V.A.C. machine. Close all tubing clamps. Connect the dressing tubing to the canister tubing.

• 14

  Press the green "Power" button located on the side of the machine. Press the "Therapy" button to access the therapy menu. Press the arrow button to increase or decrease the negative pressure level according to the orders you have received from the physician. Pressure should be increased in the case of excessive drainage, large wound surface area, or if the wound cover seal is weak. The pressure should be decreased in the case of underlying vascular disease, or excessive periwound damage.

• 15

  Select the "Continuous Therapy" mode. Select the intensity level. The intensity level is the rate of change of the negative pressure per second. The recommended therapeutic level is 10 mmhg. Lower the intensity level for patients who are experiencing discomfort during the pull down and release portions of the treatment.

• 16

  Press "Exit" to return to the main menu screen.

• 17

  Open the clamps on the tubing and press the "Therapy On" key to begin the treatment. The foam dressing should begin to compress and have a shriveled appearance. Check the tubing and drape for air leaks if the dressing does not compress. Add more tape to the covering to seal any leaks.

• 18

  Document the date and time of the treatment, the patient's tolerance, wound appearance, medications administered, and any changes in treatment.

• 19

  Close clamps and press the "Therapy Off" button when the treatment has completed. Wait thirty seconds for the foam dressing to re-fluff. Lift the corner of the drape and gently stretch it horizontally to release the adhesive. Peeling back vertically may strip the underlying skin. Remove the foam from the wound. Apply sterile saline to remove any pieces that become stuck in the wound. Discard dressing and tubing.

• 20

  Remove the treatment canister and date it. The canister may be used for up to seven days or until full. Remove and discard your gloves. Wash your hands with soap and hot water.