WOC nurses play an important role during the VAC therapy sessions. They need to assemble and keep the unit and the disposables items in place. They need to count the number of foam pieces introduced into the wound at the beginning of the therapy and recheck the count when the dressing is changed. The nurses must respond to the alarms and act accordingly. They must have a watchful attitude for bleeding and excess fluid drainage. Time and again they must check whether the tubes are in place. WOC nurses must be able to identify signs of infection and inform the physician accordingly. They must change dressings with sterile precautions.
WOC nurses must titre negative pressure concentrations as per the requirements of the wound and the patient. Side effects of VAC therapy VAC therapy can cause increased bleeding in wounds with increased tendency to bleed. The bleeding can even have fatal repercussions. The therapy can increase the number of colonizing bacteria even in non-infected wounds (Khashram et al, 2009). In small children, elderly and those with fluid losses occurring through other ports, there is increased risk of dehydration and electrolyte imbalance. Cost of treatment VAC therapy is a costly treatment. The VAC machine is usually hired.
Other than this investment, charges occur for disposable foam dressings, drainage tubes, canisters and adhesive drapes which can account for about 25 pounds a day. Some authors like Philbeck et al (1999) argue that since the wounds heal much faster with fewer complications, on the whole, this form of treatment is more cost effective. Areas of future research With the cochrane review statement, much research is warranted before it is declared that VAC therapy is superior to other forms of wound therapy. Currently VAC therapy is seen as a hope to allow take of bioengineered grafts in diabetic foot ulcers (Espensen et al, 2002).
Sinna et al (2009) used VAC therapy to procure artificial dermis is place, but routine use of VAC therapy for such a purpose warrants more research. VAC therapy is also seeking place in the treatment of Fournier’s gangrene (Tucci, 2009) and treatment of mediastinitis associated with cardiac and aortic surgeries. Conclusion VAC therapy is an advanced technology-related therapy for chronic and large wounds. The therapy employs negative pressure vacuum to decrease edema of the wound and thus enhances perfusion and formation of granulation tissue which are essential for wound healing.
VAC therapy can be used for a wide-range of wounds both in the hospital and at extended-home care settings. However, it requires proper expertise and discipline to implement it for best results. The therapy has very minimal complications if proper precautions are taken and warnings are foreseen.
References
Argenta, L. C. and Morykwas, M. J. (1997). Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. , 38(6), 563-576. Blume, P. A. , Walters, J. , Payne, W. ,Ayala, J. and Lantis, J. (2008).Comparison of Negative Pressure Wound Therapy Using Vacuum-Assisted Closure with Advanced Moist Wound Therapy in the Treatment of Diabetic Foot Ulcers. Diabetes Care, 31, 631- 636. Bucalo, B. , Eaglstein, W. H. , Falanga, V. (1993). Inhibition of cell proliferation by chronic wound fluid. Wound Repair Regen, 1 (3), 181–6. Espensen, E. H. , Nixon, B. P. , Lavery, L. A. , and Armstrong, D. G. (2002). Use of Subatmospheric (VAC) Therapy to Improve Bioengineered Tissue Grafting in Diabetic Foot Wounds. Journal of the American Podiatric Medical Association, 92(7), 395-397.