Advanced VAC Therapy: When is the Right Time to Step Up Your Game?

Kimberly Hall, DNP, RN, GCNS-BC, CW­CN-AP

When V.A.C. VERAFLO™ Therapy has made a difference in my clinical practice

Advanced VAC Therapy

 

Kimberly Hall

Kimberly Hall, DNP, RN, GCNS-BC, CWCN-AP

For some of us, V.A.C.® Therapy has been a mainstay for decades. But even as some of the most experienced clinicians, we know that sometimes we just need something else–something—more? What do we do when patients who have been on V.A.CTherapy for a week and that granulation tissue isn’t quite as beefy red as we would have expected or hoped for? Or maybe the wound that seems to have stalled and just won’t budge even though you’ve seen V.A.C.® Therapy heal a similar wound in the same amount or less time? How about the wound that you’re using V.A.C Therapy on but every time you do a dressing change, that layer of wet yellow slough in the base of the wound keeps returning like a bad habit, despite using all the tricks up your sleeve for additional chemical and mechanical debridement? Then what?

In tricky situations, such as these, how often have you given the patient a “V.A.C.® Therapy vacation” because you’re hoping that using a different treatment will jumpstart the wound or “trick it” into healing? I can certainly say I am guilty of doing this! Most Wound Care Specialists who have been doing this work for a while have seen great outcomes with V.A.C.® Therapy, but how many times have we said, “If only I could get this wound cleaned up faster, I could start V.A.C.® Therapy already!”?

Sometimes NPWT just isn’t enough

If these are things you often hear yourself saying to yourself or venting about to your co-workers, then I would urge you to consider some adjunct treatment to supplement your V.A.C.® Therapy. What does “adjunct therapy” mean in relation to V.A.C.® Therapy? One of the most recent, and in my professional opinion, most exciting new technologies to hit the wound care world has been the introduction of Negative Pressure Wound Therapy with Instillation (NPWTi-d). Acelity has dubbed this V.A.C. VERAFLO™ Therapy and a more recent addition includes V.A.C. VERAFLO CLEANSE CHOICE™ Dressing.

What is Negative Pressure Wound Therapy with Instillation?

V.A.C. VERAFLO™ Therapy combines V.A.C.® Therapy with automated instillation of a topical wound solution and its removal. The benefits of using instillation is that a topical wound cleanser, antimicrobial, or antiseptic solution can be flushed into the wound bed to help cleanse the wound and prepare it for closure while still getting the benefits of traditional V.A.C.® Therapy. After choosing the topical solution to instill, the amount of solution instilled and the length of time the solution soaks in the wound bed are all able to be automated and customized.

This dressing makes the difference

V.A.C. VERAFLO CLEANSE CHOICE™ Dressing is a dressing that is used in combination with V.A.C. VERAFLO™ Therapy. This combination can help cleanse the wound while facilitating removal of thick wound exudate such as slough, fibrin and other infectious wound matter. The dressing is a multi-layer foam with through holes that is applied directly against the wound. The unique shape and foam material allows topical wound solutions to be distributed throughout the wound bed, while allowing thick drainage to pass up through the dressing and be removed. The use of this dressing technology allows NPWT to be used on wounds that previously we might have said “No” to.

Even when you use this therapy and dressing, you still use the same application techniques we have come to know and trust when applying V.A.C.® Therapy, such as use of skin preps or ostomy paste/rings and not overfilling the wound with foam to help to help maintain seals.  I have found that with wounds with significant slough like a sacral pressure ulcer, I choose a short dwell time, amount of time the solution sits in the wound (1 minute to 10 minutes) and increase cycle frequency or NPWT time (from 30 minutes to 2 hours of negative pressure) and increase pressure to -150mmHg.  I have seen dramatic removal of slough using normal saline and not had leak issues.

Case Study – http://www.veraflo.com/wp-content/uploads/2017/01/Hall-pressure-ulcer-DSL16-1232-US-REV1-17-66859-1.pdf

 

Click HERE for a publication with other application suggestions to help make it easier on you.

As Wound Care Specialists, we are creative, determined and passionate about patient care and outcomes.  It is not often we have products that revolutionize our specialty, but this therapy and new dressing has me saying “WOW” like I did when I first used V.A.C.® Therapy.

 

NOTE: Specific indications, contraindications, warnings, precautions and safety information exist for KCI Products and therapies. Please consult a clinician and product instructions for use prior to application. Rx only.

 

Copyright 2017 KCI Licensing, Inc. All rights reserved. All trademarks designated herein are proprietary to KCI Licensing, Inc., its affiliates and/or licensors. PRA001571-R0-US, EN (10/17)

 

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Advanced VAC Therapy: When is the Right Time to Step Up Your Game? - A clinical nurse specialist describes when Negative Pressure Wound Therapy with Instillation has made a difference in her clinical practice.

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