Why is this procedure done?
Negative pressure wound therapy is also known as NPWT. It may be called wound vacuum assisted closure or wound VAC. NPWT is a special kind of dressing used on some kinds of wounds that are healing very slowly. This kind of dressing may be used on: ‚
- Wounds that have been open a long time, like a diabetic ulcer or pressure sore.
- Incisions that are not healed.
- Infected wounds.
- Skin grafts or flaps.
- In some cases, fluid gathers in the wound area after a surgery. This fluid may raise the chance of infection. It also slows down the healing process, so the doctor may put in a drain to bring the fluid outside the body.
NPWT uses a special foam dressing that is placed in the wound, covered, and connected to a machine. The machine creates suction or a vacuum. The suction may be on all the time or may go on and off at set times. The dressing may need to be changed every 24 to 48 hours. ‚
What will the results be?
The vacuum helps get rid of swelling and increases blood flow to the wound. This speeds up and helps with healing. ‚
What happens before the procedure?
- Talk to the doctor about all the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Tell your doctor about any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
What happens during the procedure?
- The old dressing will be removed. If the dressing is sticking to the wound, the staff will wet the old dressing with saline.
- To change the dressing, the staff will:
- Clean the wound as ordered and get rid of any pieces of old foam.
- Check the wound with care. Note the size, color, drainage, and what the skin edges look like.
- Clean and dry the skin around the wound. Put a skin protectant on the skin around the wound. They may apply a clear protective dressing to the skin around the wound to help get a better seal and to protect the skin around the wound.
- Cut the foam to fit the size and shape of the wound. Do not let the foam touch the healthy skin around the wound. The wound should have enough foam in it so the foam will be close to the top of the wound when the vacuum is applied. They will note how many pieces of foam are used.
- Put the clear dressing over the foam. It should extend onto the skin around the wound about 1/2 inch (1 cm) to make a full seal.
- Cut a 1 inch (2 cm) hole in the clear dressing over the foam. Put the NPWT tubing over the hole in the clear dressing. Be sure the tubing does not rub on the patients skin.
- Connect the tubing from the dressing to the NPWT machine. Turn the NPWT machine to the ordered settings and check for air leaks. The foam will sink into the wound if there are no air leaks. Most common places for air leaks are at connection points like at the machine, in the tubing, or where the tubing is inserted into the dressing.
What happens after the procedure?
- The suction container will collect drainage from the wound. It is important to empty the container when it gets about half full or at certain times during the day. Be sure to note the amount, color, and odor of any drainage.
- Some NPWT machines are small and let you move about while you have the dressing in place. Others are larger and you may need to stay in the hospital or in bed while it is in use.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- You will learn how to:
- Wash your hands every time before and after you empty the drain or change your bandage.
- Care for the skin around the dressing.
- Empty the container.
- Care for the tube if there is a clot in it. The doctor may tell you to squeeze the tube over the clot. This should open the tube. Ask your doctor to show you how to do this before you go home.
- Measure the amount of fluid collected each day and write it down on a chart.
- Look for signs of infection. Your doctor will want to know if you have a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, if you get very red and sore around the drain, or if the fluid in the drain turns cloudy or smells. Your doctor will want to know if the skin around the drain has any fluid or pus coming out of it.
- Take extra care not to kink or pull on the NPWT tubing.
- Talk to your doctor about when it is safe to take a bath or shower. Ask your doctor about your activity level while you have your drain in place.
- Learn what to do if the pump stops working.
What follow-up care is needed?
- Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- Your doctor will tell you how long you will need the NPWT and how often you will need dressing changes.
What problems could happen?
- Bleeding
- Pain
- Infection
- Clot in the tube
When do I need to call the doctor?
- Signs of infection. These include fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, if you get very red and sore around the drain, or if the fluid in the drain turns cloudy or smells.
- Signs of wound infection. These include swelling, redness, warmth around the wound, too much pain when touched, yellowish or greenish or bloody discharge, foul smell coming from the cut site.
- NPWT becomes loose, has an airleak, or falls out
Last Reviewed Date
2016-01-07 ‚
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Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider 's advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2016 Wolters Kluwer Clinical Drug Information, Inc. and its affiliates and/or licensors. All rights reserved. ‚