Exposed organs, vessels, nerves, tendons, and ligaments.Any factors that increase patient risk for bleeding and hemorrhage.Anticoagulant or platelet aggregation inhibitor therapy.Enterocutaneous fistula – While NPWT may assist with the closure of postoperative fistulas, they may also cause enteric fistulas to form.įactors that increase a patient’s risk for adverse events with NPWT.Infection – Discontinue NPWT dressing, irrigate and debride the wound, obtain wound cultures, and initiate empiric antibiotics as prescribed.For severe hemorrhage, apply direct pressure and contact provider as surgery may be needed to control bleeding based on the source (i.e. Bleeding – Apply firm pressure to the wound surface if minor bleeding occurs during dressing changes.Pain – Premedicate prior to dressing changes.If patient experiences excessive pain during sponge removal, the sponge may be soaked with topical Xylocaine without epinephrine.If the sponge adheres to the underlying tissue, soak with saline and let it sit for a few minutes prior to removal. Remove the semiocclusive dressing and carefully remove the foam sponge.Pre-medicate patient with analgesia prior to dressing change as ordered.If fragile structures are present within the wound, place an additional layer beneath the foam, such as Vicryl or petrolatum gauze.Ĭhange dressing and tubing every 48 to 120 hours (two to five days), as ordered or based on your institution’s policy. More frequent dressing changes may be needed if the wound has heavy drainage or if the wound is infected.Connect the portable pump to the suction tubing and apply settings, typically -20 to -175 mmHg of continuous or intermittent suction the polyurethane foam evenly distributes subatmospheric pressure throughout the foam creating positive pressure across the surface of the wound.Cut a hole in the adhesive sheet and apply the suction port with tubing which is connected to a disposable collection cannister.Apply the adhesive sheet to the foam dressing.Trim the foam sponge to fit the size of the open wound and place it into the wound the foam should not extend beyond the wound margin.The following steps outline the general procedure, however please consult your institution’s specific policies regarding NPWT. NPWT systems include an open-pore polyurethane ether foam sponge, semiocclusive adhesive cover, fluid collection system, and suction pump. NPWT systems cost significantly more than traditional wound dressings.The patient is required to carry a portable pump.Reduces the need for complex, subsequent reconstructive procedures.Accelerates wound healing and significantly decreases the time to wound closure in diabetic patients, improving quality of life.Customizable to almost all types of wounds including circumferential extremity wounds and wounds located close to orthopedic fixation frames.Dressing changes are required less frequently (i.e.Prophylactic therapy to prevent surgical wound infectionsĪdvantages of NPWT Compared to Traditional Forms of Wound Therapy (Gestring, 2022).Meshed grafts, to either secure the graft in place or improve epithelialization.Skin flaps and preparation for skin graft sites in reconstructive surgery.Following surgical debridement of acute or chronic wounds (i.e., orthopedic, necrotizing infection, post-sternotomy mediastinitis).Open abdominal incisions or dehisced surgical wounds.Wounds that benefit most from NPWT (Wound Care Centers, n.d.) Facing Ethical Challenges with Strength and Compassion.Establishing Yourself as a Professional and Developing Leadership Skills.
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