Negative pressure wound therapy
Background
- Also known as a "wound vac"
- A technique for treating acute and chronic wounds by using a sealed wound dressing attached to a vacuum pump.
- The vacuum creates a negative pressure gradient that draws out fluid and increases blood flow to the area.
- Often applied to wounds that are expected to heal poorly, such as diabetic foot ulcers, pressure ulcers, or very large tissue defects.
Efficacy
- High quality evidence exists for improved outcomes in the treatment of diabetic foot ulcers.
- Poor quality or insufficient evidence suggests may improve treatment of bedsores, large tissue defects, or other wounds.
- There is little evidence to suggest an increased risk of complications, so wound vacs are often applied to many other kinds of wounds.
Contraindications
- Malignancy in the wound
- Untreated osteomyelitis
- Non-enteric or unexplored fistulas
- Presence of an eschar
- Direct exposure of blood vessels, anastamoses, internal organs, or nerves.
Troubleshooting
- Most ER visits regarding wound vacs will be due to "the machine beeping". This is often due to loss of negative pressure in the circuit.
- This can usually be fixed by re-packing the wound and placing a new occlusive dressing over it.
- May require special supplies not available in the ER. If that is the case, most patients can still be discharged if they have expedited follow up with a home health nurse or PCP that can provide supplies.