Where indicated, negative pressure dressings have numerous advantages over conventional dressings. Here we describe some techniques that we have found useful in the application of these dressings.
A single VAC dressing set (KCI Medical Products [UK] Ltd, 11 Nimrod Way, Wimborne, Dorset, UK] can be used for multiple separate wounds. After applying the VAC sponge and occlusive dressing to the individual wounds, the VAC suction tubing is adhered to the main wound. The tubing is then incised at sites (Figs 1 and 2) corresponding to the smaller wounds and occlusive dressing used to obtain an air-tight seal over each dressing. The VAC pump is then able to produce negative pressure across multiple small wounds in series (Figs 3 and 4).
To obtain an air-tight seal in hair-bearing or sweaty regions such as the perineum, we have found it useful to lay the occlusive VAC film onto hydrocolloid dressings, which seem to adhere more strongly to these areas.
Placing Mepitel™ (Molnlycke Health Care AB [Publ], Box 13080, SE-402 52 Goteborg, Sweden) dressings (in place of paraffin gauze/nothing) under the sponge makes it easier to remove the dressing with the patient awake.
Putting some lignocaine into tube before removing dressing causes less pain.
Removing ‘Part 2’ of the adhesive film first allows for easier application of the dressing, a it is able to conform to irregular shaped beds.
Applying Compound Benzoin Tincture™ (3M Health Care, D-41453 Neuss, Germany) to the skin surrounding the wound, letting it dry and then applying the adhesive dessing gives it a better adhesion.
Figure 1 Preparing the tubing.
Figure 2 Positioning of VAC tubing.
Figure 3 Applying suction at both sites.
Figure 4 Effective suction applied at both sites evident by wrinkles in opsite.