Why and when to consider using something more than traditional negative pressure wound therapy.

iPhone® just celebrated its tenth year and is on its 7th generation of phone.  Just like any other technology, wound care dressings continue to evolve to meet the clinician and patient needs.  V.A.C.® Dressings have continued to grow and adapt.

I first got to work with V.A.C. VERAFLO™ Therapy in 2015. I had a complex patient who had a very large wound from a surgical wound dehiscence after a lymphedema thigh lobule excision. She was growing a variety of bacteria, and the surgical team managed her wound with Acetic Acid packings BID. After a week and a half of no clinical improvement, heavy nursing time, and use of IV narcotics, they called the wound care team for management. I applied V.A.C. VERAFLO™ Therapy with 100mL of 0.25% acetic acid to her wound and was able to transfer her to a lower level of care within one week.

She was off IV narcotics, and the wound was protected from any incontinence.

So the benefits of V.A.C. VERAFLO™ Therapy were apparent:

  • cleanse the wound through instillation
  • remove solubilized wound debris and infectious materials
  • promote granulation tissue formation and perfusion during the V.A.C.® Therapy cycle
  • help prepare the wound for closure, and provide contained and controlled wound irrigation.
VeraFlo Therapy

(click to enlarge)

I was a hero to the case manager, utilization review, nursing staff, the surgical team and most importantly, the patient. So then everyone started asking for this technology on their patients. General, trauma, vascular, plastic, and podiatric surgery began asking for the new “fancy” V.A.C.® Therapy. Even the internal medicine physicians wanted their patients on it because they saw the drastic improvement patients made on the therapy. Slowly, each specialty tried its hand at V.A.C. VERAFLO™ Therapy Each saw amazing results that shifted their thinking.

When I speak about V.A.C. VERAFLO™ Therapy, people often ask, “What kind of wounds do you use it on?” Honestly, there are very few wounds that would not benefit from V.A.C. VERAFLO™ Therapy and the only obstacle is that they have to be hospitalized to be able to receive the therapy.  Especially in light of managed care, getting complicated patients and wounds the most advanced therapy from the beginning is becoming more and more crucial. When you can actually see the improvement in the wound, the drainage quality, and the improved clinical status of the patient, it is exciting and encouraging. Then you read about the evidence that supports those visual changes, and it changes your entire practice of delivering and prescribing wound care.

The next generation of V.A.C. VERAFLO™ Dressings

V.A.C. VeraFlo Cleanse Choice™ Dressing


This past fall, I had the pleasure of being one of the clinicians that was able to trial the new V.A.C. VERAFLO Cleanse Choice™ Dressings. I have to say, at first I was skeptical. I was now thinking about wounds that had slough and fibrin in the base and placing V.A.C.® Therapy on them. The new dressing consists of three pieces of foam: a contact layer with 1 cm holes in it, a thin gray foam layer, and a thicker grey foam layer.  The technology of V.A.C. VERAFLO™Therapy is the same, but with a contact layer to help break up the thick wounds exudate, such as fibrin and slough.

We utilized this dressing on a variety of wounds for immediate wound cleansing when debridement was not an option for one reason or another. I loved the options I had now. I would sometimes hear from other clinicians that wounds were “un-V.A.C.-able.”  I took that as a challenge. I might be slightly competitive, but was certain that, with appropriate ancillary wound care techniques, I could use V.A.C.® Therapy on nearly any wound. Now I also have the technology and evidence to support that assumption. It not only saves the institution, the clinician and the patient’s time and money, but it helps get the wounds healed quicker.

 Even after my trial with the V.A.C. VERAFLO Cleanse Choice™ Dressing, I viewed it as a temporary dressing, one that was just used to “clean up” the wound base. It was not until I read the article “Novel foam dressing using negative pressure wound therapy with instillation to remove thick exudate,” by Teot et al., published in International Wound Journal, that I really shifted that thinking.  In Europe, they have been using V.A.C. VERAFLO Cleanse Choice™ Dressings successfully to help remove slough and fibrin when surgical debridement was not immediately available or possible.  Rather than think of V.A.C. VERAFLO Cleanse Choice™ as something to use until the operating room, I began to think of it when the patient wasn’t able to go to the OR, or an OR wasn’t available.

The Future is bright

As the future of healthcare and reimbursement options is unclear, it is good to know that the industry is working hard to continue to meet the needs of not only the clinicians, but of the patients as well. I enjoy going to wound care conferences and I get so excited to see what each company has to offer and speak with the engineers that help design the technology.  Last year, I had the pleasure of learning about V.A.C. VERAFLO Cleanse Choice™ Dressings, and now it is a standard of care in my practice.  Last year, my patients would not have had an option and now they do.  It’s amazing to think about, and only gets me more excited to see what the future holds.

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. iPhone is a trademark of Apple, Inc.  All other trademarks designated herein are proprietary to KCI Licensing, Inc., its affiliates and/or licensors. PRA001131-R0-US, EN (08/17)

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