Surgical Drains and Negative Pressure Wound Therapy in Veterinary Medicine
This article (Part 1 in a two-part series) from Today’s Veterinary Practice takes a look at surgical drains used for wounds (traumatic or surgical), drains for peritoneal and pleural spaces, and drains used in negative pressure wound therapy. This first article covers indications for drain use, types, benefits & drawbacks, and common complications.
Chronic Wounds and Negative Pressure Wound Therapy
This article from NCBI reviews current practices in the management of chronic wounds, including the role of negative pressure therapy in wound care.
This article from The National Center for Biotechnology Information (NCBI) reviews current practices in the management of chronic wounds, including costs and barriers to healing, as well as the role of negative pressure therapy in wound care.
Article on Wound Care Basics: Applying NPWT
This shared post from Wound Source reviews what healthcare providers should do when applying negative pressure wound therapy (Part 1 in a series).
We’re pleased to share this article from Wound Source, written by Samantha Kuplicki, MSN, about what to do when applying NPWT:
https://www.woundsource.com/blog/basic-training-applying-negative-pressure-wound-therapy
About the Negative Pressure Wound Therapy (NPWT) Process
In this post, we look at the types of wounds negative pressure wound therapy (NPWT) is used for and briefly describe how the process works.
Negative pressure wound therapy (NPWT) is a medical procedure that uses a vacuum, tubing and dressing to treat a wide variety of burns, acute, chronic and complex wounds. The vacuum, or “wound vac” control unit, is connected to the wound via tubing and a clean dressing that pulls fluid away from the open wound and protects the area from infection.
In this post, we’ll look at the types of wounds NPWT is used for and briefly describe the process.
Uses for NPWT
As described in our recent post on wounds and wound healing, NPWT can be used to help treat and heal:
Diabetic ulcers
Bedsores (also known as pressure ulcers)
First- and second-degree burns
Trauma and gunshot wounds
Surgical wounds, especially those with a high risk of infection
Other complex wounds with large amounts of drainage
Negative pressure therapy is often used in hospitals and clinics but can also be used in homes by visiting home health care providers.
The NPWT process has become increasingly popular over the past 20 years, in part because it is non-invasive, can be administered in many settings and provides just the right amount of moisture necessary for healing while also protecting wounds from outside contaminants, such as dirt and bacteria.
The Process
After cleaning (a process also known as debridement), a sterile, open-cell foam or gauze is cut to fit the size of the wound and packed into the opening. Next, the wound is covered with a clear, thin dressing that creates an airtight seal around the wound.
A vacuum pump, or control unit, is attached to the dressing with tubing, which pulls fluid and dead tissue away from the wound and into a collection canister. The vacuum can be adjusted to regulate the strength of the suction (from -125 to -75 mmHg, depending on the patient and the wound being treated) and the length of time.
Dressings must be changed regularly during treatment. Removal and changing of dressings is usually pain-free and minimizes damage to any new skin forming around the healing wound; however, patients can experience varying of levels of pain during NPWT, depending on the location and type of wound, so pain medications are often used alongside this therapy.
Important considerations
Negative pressure therapy can be a highly effective, efficient and economical way of treating complex and chronic wounds IF:
Healthcare providers are properly trained on procedures and use of all equipment
The wound is routinely checked for any signs of infection or change
The dressing around the wound remains clean and is regularly changed
The drainage tubes are connected properly to the collection canister
Drainage is flowing correctly into the canister (e.g., the tubes are not clogged, bent or blocked in any way) and the negative pressure seal is intact
The collection canister is monitored and changed regularly
For more information about negative pressure wound therapy and continuing education courses on NPWT for healthcare and insurance professionals, please contact The Wound Vac Company.
Wounds & Wound Healing – Part III
In this third post in our series on wound types and treatments, we’ll take a look at how negative pressure wound therapy can be used to treat complex open wounds.
In Part II of our short series on wound types and wound healing, we looked at the complications that can occur in open wounds, including infections.
In this final post in our three-part series, we’ll take a brief look at NPWT – negative pressure wound therapy – and how it can be used to treat complex open wounds.
Open Wounds and Negative Pressure Wound Therapy (NPWT)
As we noted in Part II of our wound care series, in open wounds, the skin is broken or damaged in some way, leaving the underlying area open to the air. This leaves the body exposed to potential contaminants such as dirt and bacteria, which can result in infection. Left untreated – or treated incorrectly – these infections can lead to life-threatening complications.
Over the past 20 years, negative pressure wound therapy (NPWT) has become a leading technology in the treatment of open wounds. To heal properly, open wounds need just the right amount of moisture, to be protected from infection, and – in larger, more complex wounds – help in bringing tissues back together while the skin closes. NPWT, when used properly, does all of these things.
Negative pressure wound therapy works by applying carefully controlled suction to an open wound using a special vacuum pump, hence the name “wound vac” for the control unit. The suction delivers negative pressure evenly through a dressing, such as foam or gauze.
Drainage from the wound is removed using tubing, which adheres to the dressing and is deposited into a collection canister. The dressing, suction and fluid removal also help protect the area from outside contaminants, pulling them away from the wound.
During this process, NWPT increases blood flow to the wound area and provides oxygen to the wound while removing excess fluid, so that the wound has just the right amount of moisture and can close and heal properly.
Use of NPWT
Negative pressure wound therapy can be used for a wide variety of complex open wounds, including:
Traumatic wounds, such as combat or gunshot wounds
Post-surgical wounds
Pressure ulcers (bedsores)
Diabetic ulcers
Skin grafts
When used correctly, negative pressure wound therapy serves as a powerful wound healing tool. However, it is not the right choice for every patient and it is imperative that medical staff be carefully and properly trained in the use of NPWT equipment and procedures.
Even an incorrect application of NPWT dressing can put patients at risk. Healthcare staff must ensure that when NPWT is used, the appropriate dressing and correct suction settings are in place and that they are frequently monitoring both the patient and the wound.
For more information on the proper use of NPWT and licensed training for medical staff, please contact us.
Wound Types & Wound Healing: Part II
A brief look at complications that can arise with open wounds, including common signs of infection.
In Part I of our short series on wound types and wound healing, we looked at the two main types of wounds, open and closed, and the main categories of open wounds.
Since closed wounds are not treated using wound vacs – or negative pressure wound therapy – we’ll focus in this article on the types of complications that can occur with open wounds.
Open Wound Complications
In open wounds, the skin is broken, cut or split in some way. This leaves the underlying tissue – and potentially bone, muscle and organs – open to the air, which can result in problems with overall healing.
Most small, minor wounds can be treated at home by washing the area carefully with soap and water, using a mild disinfectant to remove dirt and debris, and applying a sterile dressing or bandage to cover the area. Depending on the cause and severity, many small wounds will heal on their own in a few days or weeks.
However, even small wounds can develop serious problems. Let’s take a look at some signs of open wound complications.
Infections
Many open wounds happen due to accidents and are caused by objects that puncture or break the skin, such as metal nails or edges, knives, broken glass, teeth, wooden splinters, etc. These objects are often dirty and can carry bacteria or other organisms that get under the skin and enter the surrounding blood or tissue.
However, it’s possible for infection to occur in any open wounds, including surgical incisions.
If an open wound becomes infected, symptoms can include:
· Redness, red streaks or swelling – Initially, there may be some redness and swelling around the opening of the wound, which is normal, but if the color worsens, streaks develop (also known as lymphangitis), or swelling increases, it usually means that infection is present.
· Fluid, pus or draining from the wound – Again, it’s normal to have some clear or slightly yellow drainage, especially from surgical wounds, but if the color turns cloudy, greenish or dark, or if the area has a strong odor, this indicates a problem.
· Heat or warmth – If infection is present, the body will send additional blood cells to the surrounding area to help fight it. This can make the skin feel warm.
· Increased pain – There is often mild to severe pain at a wound site when an injury, accident or surgery takes place. However, this pain should decrease over time. Sudden or worsening pain at the site usually indicates a problem.
· Feeling sluggish, tired or feverish – A fever of over 100° for several hours, or an ongoing feeling of malaise, usually indicates that the body is trying to fight off infection.
In addition, if a wound is not healing and improving over time, this usually indicates that there may be infection present.
Severe infections in an open wound can result in problems such as lockjaw (caused by tetanus bacteria), gangrene (caused by a variety of bacteria, including Clostridium and Streptococcus), and sepsis.
Wound closing and healing
To heal properly, open wounds need just the right amount of moisture and to be protected from infection while closing.
Small wounds can be covered or closed with small adhesive strips or sterile bandages. Larger wounds, however, may require stitches, staples or other treatments to help them close and to prevent infection. Closing the wound brings separated tissue together to promote the healing process.
When treating complex open wounds, there are a variety of treatments that may be used to help the area heal. In the final post of our short series on wound types and healing, we’ll take a look at how negative pressure (NPWT) can be used to help treat and close complex open wounds.
Interested in learning more about wound vacs and NPWT? Contact The Wound Vac Company today.
Note: Important material for this article came from woundcarecenters.org.
Bedsores, pressure ulcers & wound therapy
This article explores the development & complications of bedsores and pressure ulcers, and how and why wound vacs & negative pressure wound therapy are used to heal them.
Among the problems that negative pressure wound therapy is regularly used to treat, bedsores are one of the most common. But what are bedsores? How do they develop, how are they treated and how and why is NPWT used to heal them?
In this article, we’ll take a brief look at these injuries, explain how they develop, explore possible complications, and discuss how and why wound vacs are used in healing them.
What are bedsores?
Bedsores – also known as pressure ulcers, pressure sores, pressure injuries or decubitus ulcers – are essentially skin, soft tissue and bone injuries that develop due to prolonged pressure on an area of the body. They’re called “bedsores” because they’re often seen in patients who have limited mobility and are confined for long periods of time to a bed or a chair.
Pressure ulcers can also evolve due to friction – for instance, if a patient is lying in bed and the skin has become fragile and moist, it can be rubbed and damaged by sheets or other fabric.
Pressure ulcers can develop quickly, and they appear most often in places where the bone is near the surface of the skin, such as:
On the lower back or at the base of the spine (tailbone)
Around the heels or ankles
On the elbows
On the hip
Around shoulder blades
On the back of the skull
Unfortunately, pressure sores may look small on the surface, but the damage beneath the skin is often much worse. The blood vessels next to the bone get squeezed, so the muscles and the tissues near the bone usually suffer the most.
Bedsores are common, especially in hospitals and nursing homes, where patients remain in bed for extended periods of time. In fact, according to a recent report by the National Pressure Ulcer Advisory Panel (NPUAP), approximately 2.5 million patients develop pressure injuries each year, leading to 60,000 deaths per year due to these injuries and related complications.
Early warning signs and complications
One of the first signs of bedsores is a change in skin color. The skin in the affected area usually starts to look red, purple or blue, and then develops an open sore as the wound develops through the skin and tissue below.
As the sore worsens, dead tissue can lead to drainage and fluid leakage, as well as strong odors, and the patient may develop fever. In the worst cases, deep tissue injury, muscle and bone infection, necrosis and even sepsis can result if sores are left untreated.
Treatment options
During early stages, it’s important to move the patient and release pressure from the affected area. The infected area should be kept clean and dry, and patients should increase their intake of water and protein to help with blood flow and healing.
Dead tissue must be removed (this process is called debridement) and regular inspection of the area must be completed. Antibiotics – either topical or oral – are often used to help treat infection while the wound is healing, and dressings should be applied and regularly changed.
Treatment of more serious injuries is challenging. If treated quickly and properly with a process such as negative pressure wound therapy, bedsores can heal within a few weeks, but more serious wounds can require surgery.
Negative pressure wound therapy (NPWT) and bedsores
The use of negative pressure wound therapy (NPWT) with a wound “vac” (or vacuum-assisted therapy) has proven to be a highly effective option for the treatment of pressure ulcers. During this process, a suction tube is attached over the wound, along with dressings, to:
Release pressure
Draw away moisture and remove drainage
Help close the wound
Reduce the risk of infection
In short, after the removal of dead tissue, this process takes care of all the necessary requirements for helping the wound heal.
When used properly, negative pressure helps wounds heal within 4-6 weeks at half the cost of surgery. In addition, it removes all surgical risks and potential complications, which is especially important given that nursing home and hospital patients are often poor candidates for pressure injury reconstruction surgeries in the first place.
Have more questions about healing bedsores with wound vacs or NPWT? Contact us today.