KCI V.A.C.Via v.a.c.therapy Negative Pressure Wound Therapy System Скачать руководство пользователя страница 12

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PRECAUTIONS
Standard Precautions:

To reduce the risk of transmission of bloodborne pathogens, apply standard

precautions for infection control with all patients, per institutional protocol, regardless of their diagnosis or
presumed infection status. In addition to gloves, use gown and goggles if exposure to body fluids is likely.

Continuous versus Dynamic Pressure Control

™

(DPC) V.A.C.

Therapy:

Continuous, rather

than Dynamic Pressure Control, V.A.C.

Therapy is recommended over unstable structures, such as an

unstable chest wall or non-intact fascia, in order to help minimize movement and stabilize the wound
bed. Continuous therapy is also generally recommended for patients at increased risk of bleeding, highly
exudating wounds, fresh flaps and grafts, and wounds with acute enteric fistulae.

Patient Size and Weight:

The size and weight of the patient should be considered when prescribing

V.A.C.

Therapy. Infants, children, certain small adults and elderly patients should be closely monitored

for fluid loss and dehydration. Also, patients with highly exudating wounds or large wounds in relation
to the patient size and weight should be closely monitored, as they have a risk of excessive fluid loss and
dehydration. When monitoring fluid output, consider the volume of fluid in both the tubing and canister.

Spinal Cord Injury:

In the event a patient experiences autonomic dysreflexia (sudden changes in blood

pressure or heart rate in response to stimulation of the sympathetic nervous system), discontinue V.A.C.

Therapy to help minimize sensory stimulation and seek immediate medical assistance.

Bradycardia:

To minimize the risk of bradycardia, V.A.C.

Therapy must not be placed in proximity to the

vagus nerve.

Enteric Fistulas:

Wounds with enteric fistulas require special precautions to optimize V.A.C.

Therapy.

Refer to V.A.C.

Therapy Clinical Guidelines for more detail. V.A.C.

Therapy is not recommended if enteric

fistula effluent management or containment is the sole goal of therapy.

Protect Periwound Skin:

Consider use of 3M

™

Cavilon

™

No Sting Barrier Film to protect periwound

skin. Do not allow foam to overlap onto intact skin. Protect fragile/friable periwound skin with additional
V.A.C.

Advanced Drape, hydrocolloid, or other transparent film.

• Multiple layers of the V.A.C.

Advanced Drape may decrease the moisture vapor transmission rate, which

may increase the risk of maceration.

• If any signs of

irritation or sensitivity

to the drape, foam, or tubing assembly appear, discontinue use

and consult a physician.

• To avoid trauma to the periwound skin,

do not pull or stretch the drape

over the foam dressing

during drape application.

• Extra caution should be used for patients with neuropathic etiologies or circulatory compromise.

Circumferential Dressing Application:

Avoid use of circumferential dressings except in the presence of

anasarca or excessively weeping extremities, where a circumferential drape technique may be necessary to
establish and maintain a seal. Consider using multiple small pieces of V.A.C.

Advanced Drape rather than

one continuous piece to minimize the risk of decreased distal circulation. Extreme care should be taken
not to stretch or pull the drape when securing it, but let it attach loosely and stabilize the edges with an
elastic wrap, if necessary. When using circumferential drape applications, it is crucial to systematically and
recurrently palpate distal pulses, and assess distal circulatory status. If circulatory compromise is suspected,
discontinue therapy, remove dressing, and contact a physician.

CONSIDERATIONS fOR TRANSITIONING V.A.C.

THERAPY INTO HOMECARE

WARNING:

Patients having an increased risk of bleeding complications should be treated and monitored

in a care setting deemed appropriate by the treating physician.

In addition to the contraindications, warnings and precautions for use of V.A.C.

Therapy, consider the

following before prescribing V.A.C.

Therapy for use in the home care setting.

The Patient’s Situation:

• Clinical condition (adequate hemostasis, and a low risk of active and/or large amounts of bleeding at

the wound site)