Equipment
■ Suction unit (pump).
■ Collection canister with connecting tubing.
■ Dressing per manufacturer instructions.
■ GranuFoam (black), white or silver foam dressing.
■ TRAC pad.
■ Semipermeable transparent adhesive dressing.
■ Skin preparation product or sealant.
■ Sterile 4 in. 4 in. gauze pad.
■ Clean procedure gloves.
■ 2 pairs of sterile gloves (if using sterile technique).
■ Sterile scissors (if using sterile technique).
■ Waterproof pad.
■ Bath blanket.
■ Goggles or safety glasses, mask, and protective gown.
■ 10- to 20-mL irrigation syringe.
■ Normal saline for irrigation.
■ Emesis basis.
■ Biohazard bag for contaminated materials.
Assessment
■ Assess wound type.
■ Assess for:
■ Contraindication to use of an NPWT (e.g., nonenteric or unexplored fistulas).
■ Necrotic tissue with eschar.
■ Untreated osteomyelitis.
■ Malignancy in the wound or in exposed blood vessels.
■ Anastomotic sites, organs, or nerves.
■ Assess for:
■ Active or prolonged bleeding.
■ Anticoagulant therapy or platelet aggregation inhibitors.
■ Presence of infected, damaged, irradiated, or sutured blood vessels.
■ Assess the wound for:
■ Bone fragments or sharp edges, infection, or pain.
■ Size (length, width, and depth in centimeters).
■ Location and depth of undermining or tunneling.
■ Amount, character, and odor of drainage.
■ Type and percentage of tissue present in wound bed (granulation, slough, fibrin, necrotic).
■ Periwound condition (i.e., intact, denuded, erythema, induration, or maceration).
■ Assess nutritional status.
Post-Procedure Reassessment
■ Note the patient’s response to the procedure.
■ Continue to monitor wound healing and changes in periwound tissues.
■ Monitor dressing every 2 hours to ensure it is firm and collapsed in the wound bed while therapy is on.
■ Monitor the seal of the dressing, and pressure settings.
■ Monitor for brisk or bright bleeding, evisceration or dehiscence, and symptoms of infection.
Key Points
■ Administer an analgesic if needed.
■ Select an appropriate dressing, per NPWT unit, to fill the entire wound cavity.
■ Obtain a suction pump unit as prescribed.
■ Prepare a sterile field for supplies.
■ Don sterile gloves for new surgical wounds, or clean gloves for chronic wounds.
■ Irrigate the wound.
■ Apply appropriate dressing per NPWT unit.
■ Cut the foam to fill the wound cavity.
■ Be Safe! Do not place foam into blind/unexplored tunnels.
■ Be Smart! Do not allow foam dressing to overlap onto healthy skin.
■ Connect tubing attached to the dressing to the evacuation tubing going to the collection system.
■ Be Safe! Position the tubing and connector away from bony prominences and skin creases.
■ Ensure clamps are open on all tubing.
■ Turn on the pump and set to prescribed settings.
■ Listen for audible leaks and observe for dressing collapse or pruning.
■ Change canister once a week or sooner if it fills.
Documentation
■ Record:
■ Date and time of dressing change.
■ Wound assessment: location of the wound, size (length, width, diameter), undermining or tunneling, amount and character of drainage.
■ Odor.
■ Wound bed (including type and percentage of tissue seen, and periwound appearance).
■ Evaluation of therapy with evidence of healing.
■ Treatment selected (type of NPWT, type of gauze or foam, number of pieces placed in the wound).
■ Treatment settings (pressures, intermittent vs. continuous, or variable pressures).
■ Patient response to dressing change.
 |
| A foam dressing cut to the size of the wound cavity |
 |
| Pinching up a piece of the dressing to cut a hole |
 |
| Applying the suction device for negative pressure wound therapy |
0 comments:
Post a Comment