KCI ABThera, Инструкция по эксплуатации

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4
Application of ABThera
™
(NPT) System without Medial Tension (refer to Intra-
abdominal Pressure Monitoring section under WARNINGS ) .
In some patients who are experiencing persistent IAH or ACS with the open abdomen,
medial tension may not be preferred due to potential for continued elevation of intra-
abdominal pressures. In patients at risk for or experiencing persistent IAH / ACS due to:
• ongoing hemorrhage with abdominal packing in place
• persistent or worsening bowel edema
• significant ongoing resuscitation which may result in worsening bowel edema
consider providing ABThera ™ Therapy
without
medial tension provided by the perforated
foam. To provide negative pressure therapy to the Visceral Protective Layer
without
medial
tension, place only a small section (3 inch [7.6 cm] round) of the perforated foam over the
center section of the Visceral Protective Layer (Fig. 6B).
ABThera
™
DRAPE APPLICATION
1. Holding the ABThera™ Drape, partially pull back one side of layer 1 to expose
adhesive (Fig. 7). Be sure to hold layer 1 flap back, to prevent re-adherence to drape.
2. Place the drape adhesive-side down to cover foam and intact skin, ensuring drape
covers at least a 8-10 cm border of intact periwound tissue (Fig. 8). Use any excess
drape to seal difficult areas, if needed.
NOTE:
To avoid trauma to the periwound skin, do not pull or stretch the drape over the
foam dressing. Minimize wrinkles, as they may be a source of negative pressure leaks
(refer to
PRECAUTIONS
,
Protect Periwound Skin
section).
3. Remove remaining tab 1 backing material and pat around drape to ensure an
occlusive seal.
4. Remove green-striped stabilization layer 2 (see Fig. 9 below).
5. Remove perforated blue handling tabs from drape (see Fig. 10 below).
NOTE: When using multiple pieces of drape, ensure that the edges of the drape overlap
in order to achieve a seal (see Fig. 11 below).
1
2
2
2
2
2
2
1
1
1
2
2
2
2
TUBING SET / INTERFACE PAD APPLICATION
NOTE: Do not cut off the Interface Pad or insert the tubing into the foam dressing. This
may occlude the tubing and cause the ABThera™ (NPT) Unit to alarm and could injure
underlying viscera.
1. Choose Interface Pad application site. Give particular consideration to fluid flow
and tubing position to allow for optimal flow and avoiding placement over bony
protuberances or within creases in the tissue.
2. Pinch drape and cut a 2.5 cm hole (not a slit) through the drape (Fig. 12). It is not
necessary to cut into the foam.
NOTE: Cut a hole rather than a slit, as a slit may self-seal during therapy.
3. Apply Interface Pad, which has a central disc and a surrounding outer adhesive skirt.
• Gently remove both backing layers 1 and 2 to expose adhesive (Fig. 13).
• Place Interface Pad opening in central disc directly over hole in drape (Fig.14).
• Apply gentle pressure on the central disc and outer skirt to ensure complete adhesion
of the Interface Pad.
4. Pull back on blue tab to remove pad stabilization layer (Fig. 15). ABThera ™ Dressing
application is complete. See the
PREPARATION FOR USE
section.
1
2
2
2
1
1
1
1
1
1
2
DRESSING REMOVAL
Remove and discard previous dressing per institution protocol. Completely inspect
wound, including paracolic gutters, to ensure all pieces of dressing components have
been removed. If intra-abdominal packing is present, packing material may be drier than
anticipated. Evaluate packing material prior to removal and rehydrate if necessary to
prevent adherence or damage to adjacent structures.
WARNING: Refer to Dressing Removal section under WARNINGS .
DRESSING CHANGES
Dressing changes should occur every 24 to 72 hours or more frequently based upon
a continuing evaluation of wound condition and patient presentation. Consider more
frequent dressing changes in the presence of infection or abdominal contamination.
Refer to
Application Setting section under WARNINGS .
Whenever the ABThera ™ Dressing is changed, always replace all ABThera ™ Dressing
components with components from an unopened sterile package.
REFERENCE LIST
• Kaplan M. Managing the open abdomen. Ostomy Wound Management, 2004 Jan;
50(1A suppl); C2, 1-8
• Kaplan M, Banwell P, Orgill DP, Ivatury RR, Demetriades D, Moore FA, Miller P, Nicholas J,
Henry S, Guidelines for the Management of the Open Abdomen. WOUNDS. 2005 Oct;
17(Suppl 1); S1S24
• Garner GB, Ware DN, Cocanour CS, Duke JH, McKinley BA, Kozar RA, Moore FA.
Vacuum-assisted wound closure provides early fascial reapproximation in trauma patients
with open abdomens. The American Journal of Surgery, 2001 Dec; 182(6); 630-8
• Barker DE, Kaufman HJ; Vacuum Pack Technique of Temporary Abdominal Closure;
A 7-Year Experience with 112 Patients. Presented at the 59th Annual Meeting of the
American Association for the Surgery of Trauma. September 16-18, 1999. Boston Mass.
Fig. 6B
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 8
Fig.10
Fig. 11
Fig. 7
Fig. 9