VACUUM ASSISTED CLOSURE (VAC) THERAPY An 真空辅助闭合（VAC）治疗.ppt

VACUUM ASSISTED CLOSURE (V.A.C.) THERAPY: An Advanced System for Wound Healing in the Home Setting Susan E. Duffield, BSN, RN, CWOCN Learning Objectives Define Negative Pressure Wound Therapy (NPWT) Discuss guidelines for the appropriate use of NPWT Identify patients with wounds who would benefit from NPWT and patients for who this modality would be contraindicated. Discuss guidelines for the application of NPWT. Explain the basic steps in obtaining insurance reimbursement for NPWT in the home care setting. V.A.C. Therapy a.k.a. NPWT NPWT applies continuous or intermittent sub-atmospheric pressure, or suction, to the wound bed via a computerized vacuum pump attached to an open-cell foam sponge that is placed in the wound and secured with an adhesive semi-occlusive dressing. Wound fluids are evacuated via a tubing system placed on the foam at one end and connected to a disposable canister housed in the therapy unit on the opposite end. The V.A.C. System Manufactured by Kinetic Concepts, Inc., San Antonio, TX. Clinical Benefits of V.A.C. Therapy Maintenance of moist, protected environment Removal of excess interstitial fluid from the wound periphery Increased local vascularity Decreased bacterial colonization Quantification/qualification of wound drainage Increased rate of granulation tissue formation Increased rate of contraction Increased rate of epithelialization V.A.C. Therapy Indications Acute wounds Full-thickness surgical wounds Chronic wounds Stage 3 pressure ulcers Stage 4 pressure ulcers Diabetic ulcers Venous stasis ulcers Traumatic wounds Dehisced wounds Stage 3 Pressure Ulcer Full thickness skin loss involving damage or necrosis of subcutaneous tissue that may extend down to (but not through) the underlying fascia. The ulcer presents clinically as a deep crater with or without undermining adjacent tissue. Kinetic Concepts, Inc. Stage 4 Pressure Ulcer Full thickness skin loss with extensive destruction; tissue necrosis; or damage to muscle, bone or sup