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Purpose: Demonstrate the versatility of VNPWT* utilizing multiple techniques of dressing applications.
Problem:
Patient A had trauma wound to groin with tunneling of 31.5cm.
Patient B had traumatic torso evisceration with enterocutanous fistula (EF).
Patient C had necrotizing fasciitis surgical wound with tunneling and undermining.
Patient D had surgical site with EF and undermining following a total exenteration.
Past Management:
Patient A foam NPWT± with foam stuck in blind tunnel.
Patient B dry gauze and wall suction changed every day with complication of leaking dressing.
Patient C foam NPWT± with white foam±± in base of wound.
Patient D foam NPWT± with leaking dressing.
Current Management:
Patient A gauze with drain† and VNPWT*.
Patient B pouching system+, drain† and VNPWT*.
Patient C foam** was applied over all edges. Grooved drain†† placed in tunneled area attached to VNPWT*.
Patient D gauze, standard drain‡, and VNPWT*.
Results:
Patient A tunneling decreased to 6 cm resulting wound volume reduction of 81%. The drain† enabled staff to irrigate wound with medication as needed, decreasing frequency of dressing changes and decreasing patient pain.
Patient B had one week wear time and wound volume reduction of 99%. Patient was able to participate with daily physical therapy without disruption due to frequent dressing changes.
Patient C tunnel decreased to 7 cm resulting in 46.2% wound volume reduction in 9 days.
Patient D no longer had undermining with 78% wound volume reduction.
Conclusion: VNPWT* provides positive wound outcomes and versatility utilizing many dressing options.
Problem:
Patient A had trauma wound to groin with tunneling of 31.5cm.
Patient B had traumatic torso evisceration with enterocutanous fistula (EF).
Patient C had necrotizing fasciitis surgical wound with tunneling and undermining.
Patient D had surgical site with EF and undermining following a total exenteration.
Past Management:
Patient A foam NPWT± with foam stuck in blind tunnel.
Patient B dry gauze and wall suction changed every day with complication of leaking dressing.
Patient C foam NPWT± with white foam±± in base of wound.
Patient D foam NPWT± with leaking dressing.
Current Management:
Patient A gauze with drain† and VNPWT*.
Patient B pouching system+, drain† and VNPWT*.
Patient C foam** was applied over all edges. Grooved drain†† placed in tunneled area attached to VNPWT*.
Patient D gauze, standard drain‡, and VNPWT*.
Results:
Patient A tunneling decreased to 6 cm resulting wound volume reduction of 81%. The drain† enabled staff to irrigate wound with medication as needed, decreasing frequency of dressing changes and decreasing patient pain.
Patient B had one week wear time and wound volume reduction of 99%. Patient was able to participate with daily physical therapy without disruption due to frequent dressing changes.
Patient C tunnel decreased to 7 cm resulting in 46.2% wound volume reduction in 9 days.
Patient D no longer had undermining with 78% wound volume reduction.
Conclusion: VNPWT* provides positive wound outcomes and versatility utilizing many dressing options.
*Smith & Nephew EZ-Care.
±KCI Wound VAC
±±KCI Versa Foam
† Smith & Nephew Wooding Scott Drain
+ Coloplast Fistula and Wound Management Device
**Smith & Nephew Foam Dressing Kit
††Smith & Nephew Channel Drain
‡Smith & Nephew Flat Drain