Week 6 | Negative Pressure Basics (17180-SP)

Photo of negative pressure therapy applied.

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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
  • PICO
  • 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:

  1. Discuss negative pressure (NP) history, development and use. 
  2. Identify patient factors that must be evaluated prior to NP placement decisions.
  3. Explain and state the absolute contra-indications of NP. 
  4. Develop plan for goals of wound care using negative pressure.
Course summary

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

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