The Use of Negative Pressure Wound Therapy

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The Use of Negative Pressure Wound Therapy

• Lisa A. Davis, M.D.

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Negative Pressure Wound Therapy

• V.A.C.
• Vacuum Assisted Closure Dressings
• Combines open-celled sponge with occlusive
  dressing, a vacuum, and a reservoir to collect
  drainage

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Background

• Developed by Louis Argenta, MD Michael
  Morykwas, PhD from Wake Forest University
• Received FDA clearance to market in 1995
• Has been used to treat thousands of pts with
  acute chronic wounds in hospitals, ECFs at
  home.

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How It Works

• Keeps wound moist to encourage healing
• Physical forces of vacuum help to draw wound
  edges inward
• Draws out excess fluid
• Increases perfusion pressure to wound

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Advantages

• Increased granulation formation
• Decreased pain
• Decreased bacterial counts
• Decreased nursing time

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Studies Show

• Decreased interstitial edema
• Increased local blood supply
• Decreased bacterial colonization

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Who is Prescribing the VAC

• Plastic Surgeons
• Orthopedic Surgeons
• Vascular Surgeons
• General Surgeons
• Podiatrists
• Primary Care Physicians
• ETs / Clinical Nurse Specialists

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Types of Wounds

• Stage III IV pressure ulcers
• Dehisced incisions
• Compromised flaps grafts
• Acute traumatic wounds
• Chronic wounds or ulcers with Exposed tendons or
  hardware

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Types of Wounds - cont.

• Over new skin grafts flaps
• Chronic ulcers
• (venous, arterial, diabetic)
• Burns
• Acute abdominal wounds
• when fascial closure is not possible

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Contraindications

• Necrotic tissue
• Untreated osteomyelitis
• Malignancy within the wound
• Fistulas to organs or body cavity
• Placement over exposed arteries or veins

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Precautions

• Active Bleeding
• Pts on anticoagulants
• Placement in close proximity to weakened,
  irradiated or sutured blood vessels

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Cost Effective

• Reduce hospital LOS
• Reduce of dressing changes
• Reduce home health nursing visits
• Excellent adjunct to surgery
• Allows simultaneous treatment of multiple wounds
  in close proximity
• Effective therapy for non-surgical candidates

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PROVE IT!

• Began use in patients who had failed everything
  else

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SummaryNegative Pressure Wound Therapy

• Non-invasive active therapy using controlled,
  localized, subatmospheric pressure
• FDA cleared for promotion of healing wounds
• Assists to reduce edema, increase perfusion,
  promote granulation tissue formation, decrease
  bacterial colonization
• Indicated for many types of problem wounds