My Story..My Life...

Finally saw something new in the ward today! Well, not exactly a NEW thing....just a therapy I've heard of so many time but never actually got around to see the REAL THING. That's right, it's the VAC therapy.

Well, I am just writing this so I will not forget what I have learnt today.
For the dressing trolley, I will need a probe or a wound swab, a Duoderm Thin, a Mepitel or Atraumen, a pair of sterile scissor and a sterile penknife.

First, check the patient's wound (and read up his notes) to make sure that the patient's wound is not connected to any fistula. Probe around the wound's wall to ensure that all surrounding wall is intact. This is to make sure that when the vacuum is applied, no other matter (such as faeces or bowels) will be sucked away.

Second, place a piece of Mepitel in the wound where there are sutures. This is to protect the sutures but do not cover up the entire wound because this will slow down granulation. Next, apply a layer of Duoderm Thin around the wound. This will help keep the suction firm and prevent air leak.

From the dressing pack from the VAC company, cover the wound with the black foam. Cut accordingly to the size of the wound. If the wound is deep, just pack the wound with several layers of foam. Then apply the thin clear dressing over the foam and wound. That thin clear dressing looks very much like a Tegaderm Film or a C-view. Ensure that the thin dressing is sealed at all ends to prevent air leakage.

Cut a small hole (about 1cm diameter) in the middle where the foam is and connect it to the suction, which will be connected to the cannister. The cannister will contain a special gel that will mixed with the exudate sucked from wound to prevent frothing.

According to research, the optimal pressure is found to be 125mmHg. For the first two days, the pressure will be applied continuously. After 48hrs, the wound will be reassessed to see if the pressure can be applied intermittently. Why is that so? If you think about yourself being slapped by someone continuously for 2 hours, your face will be numbed. However, if you are slapped by someone with a two minutes break between each slap, the impact will be stronger. The idea is to provoke the cells to regenerate faster with greater impact felt. The exudate from the wound is able to pass through those tiny pores in the foam and into the cannister when the machine is running. The reason why the pressure is not intermittent for the first 48hours is because the exudate might settle in the foam and cause stagnantion.

I always thought that the VAC therapy is expensive. The trainer told me it does cost more than other conventional dressings (it is 35 pounds a day to rent the machine) but it is more cost-effective because the wound will heal 60 times faster.

I am really impressed by these new knowledge. As for now, if the patient does not get discharged yet, I will be able to follow the progression of the wound. :D

- i just wanted to say ...# ;