Week 6 | Negative Pressure Basics (16181-SP)
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1. Negative Pressure in Wound Closure
- Modalities different around world, products used to manage wounds changing rapidly.
- Devices /dressings used today smaller / provide better privacy for patient.
- Reimbursement regulations complex and changing also.
- Information in this module is not all inclusive, but basic principles are covered.
2. Negative Pressure Wound Therapy - Terminology
- Controlled application of sub-atmospheric pressure to a wound using an electrical pump to intermittently or continuously convey sub-atmospheric pressure through connecting tubing to a specialized wound dressing.
- Term wound VAC or just “VAC “is a trademarked name KCI received FDA clearance to market only NP device in 1995, now sold to Acelity/KCI
- Today, there are many negative pressure applications– some come as devices, some as dressings
3. Wound Closure Impediments
- Edema, Infection/Colonization , Poor Blood Supply , Paucity of tissue, Scar/Trauma
4. Know contraindications:
- Exposed vasculature, Malignancy in the wound, Untreated osteomyelitis, Non-enteric or unexplored fistula, Slough, necrotic tissue or eschar, Exposed anastomotic site, Exposed organs, Exposed nerves
5. KCI Product Advancements
- Older devices retired
- New devices offer new functions
6. Smith & Nephew Introduction of New Products
- RENASYS™ System from Smith & Nephew
- Uses gauze or foam - Standard pressure for gauze is 80mmHg, for foam, 125 mmHG
- Open Abdomen
7. Snap Wound Care System
- Mechanically powered negative pressure, created by mechanical means (uses a spring), rather than battery or electrical power, blue foam added to provide better visualization of exudate.
8. Consider stopping negative pressure when there is…
- Achievement of goal of therapy
- Significant progress toward wound closure, and desire to be less aggressive
- Adequate preparation for surgical intervention
- No progress in wound healing for 1-2 weeks and applied solutions have failed
- Non-compliance by the patient with NPWT
9. The Take Away on Use of Negative Pressure
- All patients, situations and needs are different
- Devices also vary
- Based on patient assessment, select appropriate device
Objectives for Learning Outcomes
After completing this session, you will be able to:
- Discuss negative pressure (NP) history, development and use.
- Identify patient factors that must be evaluated prior to NP placement decisions.
- Explain and state the absolute contra-indications of NP.
- Develop plan for goals of wound care using negative pressure.
Betty Hanrahan, MSN, CNS, ARNP-BC, CWCN-AP, CWS, FACCWS, CFCN
Certified Wound Care Nurse; Co-Director, Wound Management Education Program (WMEP) and Wound Management Fundamentals Course (WMFC), Continuing Nursing Education, University of Washington School of Nursing, Seattle; Fellow, College of Certified Wound Specialists