PORTSMOUTH HOSPITALS NHS TRUST
VACCUM ASSISTED CLOSURE THERAPY GUIDELINES
MANAGEMENT OF VACUUM ASSISTED CLOSURE THERAPY. Issue 1. 28.12.2006
TITLE
Management of Vacuum Assisted Closure Therapy
MANAGER /
COMMITTEE
RESPONSIBLE
Tissue Viability Clinical Nurse Specialist
Mr Mark Pemberton, Vascular Consultant
NMCEC
DATE ISSUED
28.12.2006
VERSION
1
REVIEW DATE
December 2007
Equality Impact
Assessment has
been applied to this
policy
B. Topley. Tissue Viability Clinical Nurse Specialist
AUTHOR
Barbara Topley Tissue Viability – Clinical Nurse Specialist
RATIFIED BY
PROFESSIONAL ADVISORY COMMITTEE – 05.12.2006
CONTENTS:
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
INTRODUCTION
STATUS
PURPOSE
SCOPE/AUDIENCE
DEFINITIONS
CLINICAL PRACTICE GUIDANCE
SUPPORTING EVIDENCE
ASSOCIATED DOCUMENTATION
DUTIES AND RESPONSIBILITIES and Audit Standards/Audit Tool
TRAINING
APPENDICES:
1.
2.
3.
4.
5.
6.
FLOW CHART FOR VAC THERAPY
INDICATIONS FOR USE OF VAC THERAPY
THE DIFFERENT TYPES OF VAC DEVICES, CANISTERS AND DRESSINGS
PRESSURE SETTINGS
SAFE DISCHARGE
COMPETENCY LEVELS
Control Date: 12/02/16
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PORTSMOUTH HOSPITALS NHS TRUST
VACCUM ASSISTED CLOSURE THERAPY GUIDELINES
MANAGEMENT OF VACUUM ASSISTED CLOSURE THERAPY. Issue 1. 28.12.2006
1. INTRODUCTION
Vacuum Assisted Closure (VAC) is a therapy that can be used on a variety of acute and chronic wounds to
achieve either wound closure or prepare the wound bed for further surgical interventions. It has the potential
to reduce morbidity and mortality associated with chronic wounds, is an alternative treatment modality when
other conventional treatments fail or if patients are unable to undergo surgery. Appropriate use of this therapy
has the potential to reduce length of hospital stay, reduce the risk of healthcare associated infections and
improve patients’ quality of life.
2. STATUS
Clinical Guideline
3. PURPOSE
This guideline has been developed to support nurses to manage a wide variety of wounds using VAC therapy
appropriately and safely at all Competency Levels.
4. SCOPE/AUDIENCE
This guideline applies to all healthcare professionals who have been deemed competent to apply VAC therapy
on the QA site within the Surgical division, Dept of Critical Care, Renal Unit. It may be applied on the RHH site
but only with the support of Senior Nursing Staff in Plastics. A practitioner who can demonstrate detailed
knowledge of the device; its application and uses as well as its side effects must only prescribe VAC therapy.
Patients requiring VAC therapy outside of the above departments must be discussed with Tissue Viability and
the surgical division prior to commencing treatment.
5. DEFINITIONS
Chronic wounds can be described as wounds that have not responded to surgical or medical treatment and
are more likely to be present in the elderly or in people with multi-system failure1. Chronic wounds include
pressure ulcers, venous and arterial leg ulcers, diabetic foot ulcers and fungating wounds. Acute wounds are
those that usually heal without complications, for example: surgical incisions on a healthy patient. However
any wound can develop complications that can lead to delays in wound healing2. Patients with complex
wounds invariably have complicated, underlying health problems with multi-factorial clinical signs and
symptoms that will deal wound healing3.
6. CLINICAL PRACTICE GUIDANCE
Action
A Competent Level 3 trained staff
should carry out a thorough wound
assessment on all identified patients2
Wound selection criteria4, 5
Refer to (Appendix 1)
Explain to patient reasons why VAC
therapy was chosen and document in
the patient’s medical records. Give
patient leaflet information about VAC
Therapy
Notify Tissue Viability Team when
commencing VAC therapy but
complex wounds must be referred
Control Date: 12/02/16
Rationale
The outcome of the assessment should be documented in the Trust’s Wound
Assessment and Care Plan
To identify suitability for VAC therapy as some wounds are contra-indicated for
Vac therapy
VAC therapy should only commence with the agreement of the patient and their
consultant
VAC therapy may be used in certain circumstances when it is contra-indicated
although only with the approval of a Tissue Viability Nurse. This will need to be
discussed with the patient and their relatives (Appendix 2) and documented
In these circumstances, the prescriber is accountable and responsible for the
outcome of the therapy
Tissue Viability Team will guide and support ward staff to ensure safe
application of VAC therapy for all patients with complex wounds
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PORTSMOUTH HOSPITALS NHS TRUST
VACCUM ASSISTED CLOSURE THERAPY GUIDELINES
MANAGEMENT OF VACUUM ASSISTED CLOSURE THERAPY. Issue 1. 28.12.2006
Action
Applying the dressings6
Refer to (Appendix 3)
Rationale
PHT currently have available 3 types of pumps and 2 types of foam that can be
used for applying VAC therapy
All healthcare professionals must be able to identify the differences and choose
the appropriate dressings and device
Foam should not be placed directly over exposed blood vessels or organs. This
should be covered with natural tissues (membranes or muscle), mesh or multiple
layers of non-adherent dressings
White foam may be placed directly over Vicryl/prolene mesh, or intact
peritoneum.
If there are large volumes of exudate, increase pressures by 25 – 75 mmHg until
it reduces except in the management of Diabetic Feet
Vac therapy can still be applied if deep tension sutures are in situ but it is easier
to dress and maintain seal if they are removed with the Consultant’s approval
If patients experience discomfort, use continuous therapy and follow Pain
Assessment guidelines
If patients are on anticoagulants, ensure INR is stable and, if no evidence of
active bleeding, start with lower pressure and slowly titrate to 125mmHg
Using more than one piece of foam or
This should be recorded in the patients notes to ensure safe removal of all
a combination of foams and silicone
pieces of foam and silicone dressing if used to line the wound bed
dressings
The undermining and tunnelled areas must be measured before inserting foam
into these areas
Foam should be cut 1- 2 cm longer than the tunnel measures, should be placed
Care should be taken when inserting in the distal part of the tunnel and the end of the foam should be in contact with
foam into areas of undermining and
foam in the wound bed. This allows the distribution of higher pressures to
6
tunnelling
collapse the edges of the wound together allowing the wound to granulate
Foam should be gently placed into the distal areas of undermining and not
forced in. This allows the distribution of higher pressures to collapse the free
areas of undermining together allowing the wound to granulate together from the
distal portion
It is possible to use a bridging technique to apply VAC therapy. A Y-connector
Multiple wounds
can be used if the patient has more than one wound that requires VAC therapy
To optimize the benefits of VAC therapy, it should remain active
Optimal therapy 4,6,7 (Appendix 4)
Pressure settings range between 50mmHg – 200mmHg and are set according to
the wound type
It can be applied either continuously or intermittently depending on the site,
volume of exudate and patient’s level of pain
If the therapy is turned off for more than 2 hours in a 24 hour period, the therapy
must be discontinued and replaced with conventional dressings
The first dressings should be removed out after the first 48 hours
Subsequent dressing changes: 2 or 3 times weekly depending on foam used and
if interface dressing is used
Dressing changes4, 8
Use non-adherent dressing to protect underlying structures
In the presence of significant infection, dressings should be changed every 1224 hours
The VAC device will alarm when the canister is full and it should be changed
Changing the disposable canister
immediately. As the canister is a single use item, it should be changed at each
dressing change or if exudates is low once a week.
Control Date: 12/02/16
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PORTSMOUTH HOSPITALS NHS TRUST
VACCUM ASSISTED CLOSURE THERAPY GUIDELINES
MANAGEMENT OF VACUUM ASSISTED CLOSURE THERAPY. Issue 1. 28.12.2006
Action
Monitoring the wounds9
Management of fistula6
Infected wounds10
Odour6, 8
Pain2, 4,9
Bleeding9
Skin reaction
Prevention of pressure damage from
tubing4
Discontinuation of therapy4, 9
Control Date: 12/02/16
Rationale
Wounds must be monitored for signs of complications including: bleeding,
maceration, pain, odour, skin reaction, pressure damage from tubing
If there is a marked deterioration in the wound, or the surrounding skin or if the
wound becomes very dry, VAC therapy should be discontinued and medical staff
informed
The therapy should be discontinued immediately if there is rapid bleeding and
medical staff informed
The wound must be monitored to ensure that the therapy is maintained
The Tissue Viability Team should be contacted for further advice
VAC therapy can assist in the healing of enteric fistula although results cannot
be guaranteed. Refer to the Tissue Viability Team or a Level 4 Practitioner and
the patient’s Consultant before applying VAC therapy
More frequent dressings changes may be necessary
Observe and report clinical signs of infection to medical staff
Interaction between foam and exudate may cause odour and dressings may
need to be changed more frequently
Increasing odour could indicate infection and medical staff should be informed
All patients to undergo a pain assessment as analgesics will be required at
dressing changes or when VAC therapy is applied
There are also rare occasions when patients may have to go to Theatre initially
to have the dressings changed
Consult with Acute Pain Team as necessary
If patients report continuous pain, not controlled by analgesia, VAC therapy can
be reduced in increments of 25mmHg until pain is relieved
This can be titrated up as the pain improves or is controlled
Increased pain may indicate infection in the wound therefore medical staff should
be informed. VAC therapy may need to be discontinued if pain is not controlled
Blood stained exudates is common as a wound heals as granulation tissue is
well vascularised and easily traumatised .
If rapid bleeding (haemorrhaging) into canister, VAC therapy must be
discontinued immediately and medical team informed
Rapid granulation tissue formation may result in ingress of tissue into foam and
cause bleeding on removal. To reduce the risk a silicone interface dressing
(Mepitel) can be used
If foam adheres to the wound bed, to avoid trauma and bleeding, saline can be
used to soak the foam dressing prior to its removal
Occasionally patients may experience a skin reaction to the drape. Cavilon Film
or Duoderm Thin can be used to protect the peri-wound skin
The tubing from the dressing can potentially cause pressure damage. Care
should be taken to avoid this when placing the tube into the foam. To minimise
pressure from tubing over areas of skin/bony prominences, spare foam can be
used to cushion the tubing
VAC therapy should be discontinued:
 When the aim of the therapy has been met
 If no improvement in wound after 2 applications of therapy
 If ward staff are unable to maintain therapy
 If there is active bleeding
 If there is a deterioration in the wound
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PORTSMOUTH HOSPITALS NHS TRUST
VACCUM ASSISTED CLOSURE THERAPY GUIDELINES
MANAGEMENT OF VACUUM ASSISTED CLOSURE THERAPY. Issue 1. 28.12.2006
Action
Discharge planning
(Appendix 5)
Transferring patients to other
hospitals
Rationale
The Tissue Viability Team must be informed of patients being discharged on
VAC therapy.
Staff to ensure competency of community staff who will continue therapy post
discharge.
Teaching to be organised if deficit in knowledge base identified. This may result
in a delayed discharge
District Nurses must be contacted and there consent obtained for continuing
VAC therapy on patients at home
Staff must ensure patient’s will be safe at home whilst continuing VAC therapy.
i.e. risk of trips, falls etc.
Check list to be completed and returned to Tissue Viability Office
Patients can be reviewed in Tissue Viability Outpatient Clinic or as a ward
attendee
Ward staff must contact the Tissue Viability Department before a patient is
transferred outside PHT with VAC therapy. If unable to contact the Department
out of hours or at weekends, VAC therapy should be removed and conventional
dressings applied. This is to ensure PHT equipment is not lost and always
accounted for.
It is the ward staff responsibility to communicate recommended ongoing care to
the receiving hospital.
7. SUPPORTING EVIDENCE
Specific references
Specific references
1. BENBOW M (1995), Intrinsic factors affecting the management of chronic wounds, British Journal of Nursing 4 (7) pp 407410
2. FLANAGAN M (1997) Wound management Churchill Livingstone
3. BUTCHER M (1999) A systematic approach to complex wounds, Nursing Standard 15 (29) pp58-64
4. ARGENTA L C & MORYKWAS MJ (1997) Vacuum-Assisted Closure: A New Method for Wound Control and Treatment:
Clinical Experience Annals of Plastic Surgery 38 (6) pp563-576
5. THOMAS S (2001), An introduction to the use of vacuum assisted closure, World Wide Wounds
http//www.worldwidewounds.com
6. KCI Medical (2003), VAC Therapy Clinical guidelines, Oxfordshire
7. MORYKWAS M J, ARGENTA L C, SHELTON-BROWN E I ET AL (1997), Vacuum-assisted closure: a new method for
wound control and treatment: animal studies and basic foundation, Annals of Plastic Surgery 38 pp 553-562
8. DEFRANZO A J, ARGENTA L C, MARKS M W, MOLNAR J A, DAVID L R, WEBB L X, WARD W G, MCCALLON S K,
KNIGHT C A, VALIULUS J P, CUNNINGHAM M W, MCCULLOCH J M, FARINAS L P (2000) Vacuum-Assisted Closure
versus Saline-Moistened Gauze in the Healing of Postoperative Diabetic Foot Wounds Ostomy/Wound Management 46 (8)
pp 28-34
9. BANWELL P E & TEOT L (2003), Topical negative pressure (TNP): the evolution of a novel wound therapy Journal of
Wound Care 12(1) pp22- 28
10. TANG A T M, OKRI S K, HAW M P (2000) Vacuum-assisted closure to treat deep sternal wound infection following cardiac
surgery Journal of Wound Care 9 (5) pp 229-231
11. MEDICAL DEVICES AGENCY (2000) Equipped to Care: The safe use of medical devices in the 21st century Medical
Devices Agency London
12. NURSING & MIDWIFERY COUNCIL (2004) The NMC Code of Professional Conduct: Standards for Conduct, Performance
and Ethics NMC
Control Date: 12/02/16
Page 5 of 14
PORTSMOUTH HOSPITALS NHS TRUST
VACCUM ASSISTED CLOSURE THERAPY GUIDELINES
MANAGEMENT OF VACUUM ASSISTED CLOSURE THERAPY. Issue 1. 28.12.2006
8. ASSOCIATED DOCUMENTATION
Competencies for VAC therapy – Levels 1 – 4
Wound Assessment and Care Plan
Flow chart
Discharge protocol
General information leaflet
Further reading
COLLIER M (2003), Topical negative pressure Nursing Times 99(5) pp54
EVANS L& LAND L (2004), Topical negative pressure for treating chronic wounds
Cochrane Database of Systematic Reviews 3
http://gateway.uk.ovid.com/ovidweb.cgi
HIGGINS S (2003), The effectiveness of vacuum assisted closure (VAC) in wound healing
Centre for Clinical Effectiveness, MONASH University
http://www.med.monash.edu.au/healthservices/cce
Additional websites
http://www.kcimedical.com
http://www.worldwidewounds.com
http://www.nice.org.uk
http://www.mhra.gov.uk
9. DUTIES AND RESPONSIBILITIES
Members of the Tissue Viability Team are responsible for developing, implementing and monitoring this guideline.
Audit Standards/Audit Tool
Aspect of Care/outcomes
All patients should undergo an holistic assessment
prior to the application of VAC therapy
1. A wound assessment and care plan is
completed
2.The wound is evaluated at each dressing change
3.All patients receive general information leaflet
Expected Standard/Target
100%
100%
100%
Source of Data Collection
Patient records and Wound
Assessment and Care Plan
Patient records and Wound
Assessment and Care Plan
Patient records and patient
satisfaction survey
Patient records, checklist and
Tissue Viability Database
4. Patients discharged with VAC therapy have a
discharge plan and will be followed up in the
100%
Tissue Viability Outpatient Clinic
All healthcare professionals are responsible for using any medical device safely and staff applying VAC therapy must be
competent (Appendix 6). The Tissue Viability Department will be responsible for maintaining a list of competent staff.
The Medical Devices Training Team will be responsible for training staff at Competency Levels 1 and 2. The Tissue
Viability Team will be responsible for assessing staff at Competency Levels 3 -4.
10. TRAINING
All staff using VAC therapy must have received appropriate training by attending a recognised training programme
provided by either the Trust or KCI Medical11, 12. They should also have received training in wound assessment, wound
management and complete the appropriate documentation. Staff must attend a training update at least every 2 years.
Staff must be assessed in clinical practice to achieve competencies from Level 1-4
Control Date: 12/02/16
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PORTSMOUTH HOSPITALS NHS TRUST
VACCUM ASSISTED CLOSURE THERAPY GUIDELINES
MANAGEMENT OF VACUUM ASSISTED CLOSURE THERAPY. Issue 1. 28.12.2006
APPENDIX 1
Flow Chart for VAC Therapy
Wound types suitable for VAC therapy
Acute
Surgical
Skin Flaps
Skin Grafts
Trauma
Thermal
Chronic
Pressure ulcers
Leg ulcers
Diabetic foot ulcers
Wound Assessment
Consider the following:
 Size and site of wound
 Levels of exudate
 Surrounding skin
 Infection
 Pain
 Patient’s ability to cope with VAC
Complex
Simple
Type of
Wound
Simple Wounds
Shallow cavity or deeper
cavities
Minimal or no undermining
No necrotic tissue or slough
No active bleeding
Complex Wounds
Exposed organs/blood vessels
Risk of fistula formation
Existing fistula of unknown origin
Presence of malignancy
Presence of necrotic tissue
Untreated osteomyelitis
Extensive undermining/tracking
Infection
Exposed bone or hardware i.e. mesh, metal
work
Suitable for VAC
therapy
Assessed by
Expert Practitioner
Control Date: 12/02/16
Contact Tissue
Viability Team or
Level 4 Practitioner
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MANAGEMENT OF VACUUM ASSISTED CLOSURE THERAPY. Issue 1. 28.12.2006
APPENDIX 2
INDICATIONS FOR USE
Indications for use 5,6
Mains Powered Device
Portable Device
Acute/ traumatic wounds
Venous stasis ulcers
Sub-acute
Lower extremity diabetic ulcers
Pressure ulcers
Pressure ulcers
Chronic wounds
Lower extremity flaps
Meshed grafts
Dehisced incisions
Rotational/ free flaps
Grafts
Partial thickness burns
Contraindications and precautions for VAC Therapy
Fistula to organs/body cavities
Dry eschar
Untreated osteomyelitis
Malignancy in wounds
Exposed blood vessels or organs
Long term anticoagulant therapy
Haemophilia
Haemoglobinopathies, i.e. sickle cell disease
Control Date: 12/02/16
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PORTSMOUTH HOSPITALS NHS TRUST
VACCUM ASSISTED CLOSURE THERAPY GUIDELINES
MANAGEMENT OF VACUUM ASSISTED CLOSURE THERAPY. Issue 1. 28.12.2006
APPENDIX 3
THE DIFFERENT TYPES OF VAC DEVICES, CANISTERS AND DRESSINGS6
Type of pump
Classic pump:
 300 ml canisters
 Must be switched on to battery manually when disconnected from the mains
 Battery lasts 2 hours
Mini VAC pump
 Portable
 Uses 50 ml canisters
 Battery operated and lasts up to 12 hours
 Battery must be recharged
 Facility to attach to mains
ATS pump
 Different connection to Classic and Mini VAC
 Uses 500 ml canisters
 Battery lasts up to 4 hours
 Automatic transfer to battery when disconnected from the mains
Freedom pump
 Only available on rental
 Not available within PHT
 Portable pump
 Uses 300 ml canisters
 Has battery life of 12 hours
Recommended guidelines for foam use6
Type of wound
Black Foam
Deep, acute wounds with moderate
x
granulation tissue present
x
Deep pressure ulcers
x
Flaps
Painful wounds
Superficial wounds
Tunnelling/sinus tracts/undermining
Deep trauma wounds
Wounds which require controlled
growth of granulation tissue
Diabetic ulcers
x
Post graft placement (including
bioengineered tissues)
x
Shallow chronic ulcers
Control Date: 12/02/16
White foam (PVA)
Either
x
x
x
x
x
x
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MANAGEMENT OF VACUUM ASSISTED CLOSURE THERAPY. Issue 1. 28.12.2006
APPENDIX 4
Optimal settings for:
Acute traumatic wounds6
Surgical wound dehiscence6
Pressure ulcers6
Initial cycle
Continuous first
48 hours
Subsequent
cycle
Intermittent
5 min ON/ 2 min
OFF for
remaining
therapy
Target pressure Target pressure
(Black foam)
(White foam)
125 mmHg
125-175 mmHg
Titrate up if more
drainage
Dressing change
interval
Every 48- 96
hours (every 12 24 hours with
infection)
Subsequent
cycle
Intermittent
5 min ON/ 2 min
OFF for
remaining
therapy
Target pressure
(Black foam)
50-125 mmHg
Dressing change
interval
Every 48- 96
hours (every 12 24 hours with
infection)
Chronic ulcers
Initial cycle
Continuous for
first 48 hours
Target pressure
(White foam)
125-175 mmHg
Titrate up if more
drainage
Diabetic and Peripheral Vascular Foot Wounds
Initial cycle
Continuous for
duration of
therapy
Target pressure
(Black foam)
50 – 100mmHg
Titrate up by 25
mmHg if healthy,
red granulation
tissue
Discontinue if dry
and / or
discoloured
Control Date: 12/02/16
Target pressure
(White foam)
75 - 125 mmHg
Titrate up by 25
mmHg if healthy,
red granulation
tissue
Discontinue if dry
and / or
discoloured
Dressing change
interval
Every 48 – 72
hours
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APPENDIX 5 SAFE DISCHARGE
Discharging Patients on VAC Therapy
WARD---------------Patient Contact No
Patient Addressograph
District Nurse
Surgery
Contact No
To ensure safe discharge the pt and / or carer must be competent to;
Change Canister
Operate Pump
Trouble Shoot
Yes
No
Yes
No
Yes
No
District Nurse informed and agreed
To continue VAC Therapy at home
Date
Yes
No
Type of VAC Pump
Serial No of Pump
Alternative Dressings provided in case of VAC Therapy failure?
Yes
No
Wound reviewed by TV Team prior to Discharge?
Yes
No
TV Outpatient Appointment Required?
TV Outpatient Appointment arranged with TV Office
& Patient informed?
Yes
No
Yes
No
VAC Dressings & Canisters Supplied?
Yes
No
General Information Leaflet Supplied to Patient
Yes
No
Sign
Grade
Date
Date returned:
Please Send/Fax copy of Form prior to Discharge to: Tissue Viability Office, Infill Building, QAH, Fax No: 023 9228 6985
Control Date: 12/02/16
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APPENDIX 6: Competency Statement
Competency Indicators
1st Level
a. Demonstrates ability to assist a
competent practitioner in the use of
VAC therapy by informing a competent
practitioner if: -
Competency Indicators
2nd Level
Competency Indicators
3rd level
Competency Indicators
4th level
Level 1 and
a. Describes the principles of wound
management and wound assessment
Level 1, 2 and
a. Demonstrates a detailed knowledge
of the principles of VAC therapy
Level 1, 2,3 and
a. Demonstrates expert knowledge of
the scientific background to VAC
therapy
b. Able to articulate the principles of
VAC therapy
b. Undertake a holistic assessment of
the patient and complete the Trust’s
Wound Assessment and Care Plan
i. The VAC device is alarming
ii. The patient reports pain or
discomfort associated with VAC
therapy.
iii. There is any bleeding into the
canister or under the dressing
b. Identify the 3 different VAC devices
and the different dressings and
canisters associated with each device
c. Keeps patients and relatives/carers
informed of all actions
d. Ensures patient safety whilst
mobilising with VAC therapy
e. Demonstrates an understanding of
the principles of accountability for
one’s practice
f. Demonstrates an understanding of
the basic function and controls of VAC
therapy
g. Demonstrates in practice how the
different pumps are switched from
power supply to battery, and battery
Control Date: 12/02/16
c. Able to re-apply a simple VAC
dressing after initial assessment and
first application of VAC dressing by a
level 3 or 4 practitioner
c. Demonstrates knowledge of wound
types suitable for VAC therapy
d. Identify the contraindications,
precautions for and complications of
VAC therapy
d. Identify patients suitable for VAC
therapy and any potential
complications. Apply VAC therapy
without supervision
e. Demonstrates the ability to assist a
level 4 practitioner in the application of
a complex VAC dressing
e. Able to discuss with medical staff the
rationale of why VAC therapy
may/may not be suitable
f. Identify reasons why VAC therapy
should be discontinued e.g. safety,
wound changes
f. Identify adjunct dressings for use
with VAC therapy
g. Demonstrates understanding of all
the controls and pre use checks
required for VAC therapy
h. Able to rectify any problems when
pump is alarming
i. In the event of pump failure knows
how to contact Equipment
Library/Clinical Engineering for
advice. If not rectified within 2 hours,
demonstrates in practice ability to
g. Demonstrate awareness of the
potential need to protect the periwound skin
h. Select the type of foam and VAC
device to be used for each individual
and identify the optimum settings for
VAC therapy
i. Perform re-application of advanced
VAC therapy dressings after initial
assessment and implementation of
treatment from an expert practitioner,
Page 12 of 14
b. Demonstrate expertise in theory,
practice and management of VAC
therapy and dressing techniques for a
variety of wounds
c. Identify and treat complex wounds
with VAC therapy
d. Perform advanced VAC therapy
dressing applications
e. Liaise with the multi-disciplinary
team if patients have complex wounds
with complex co-morbidities and
require VAC therapy
f. Provide patients and their carers with
expert advice on VAC therapy
g. Facilitate patient discharge with
VAC therapy
h. Monitor progress of wound in Tissue
Viability Clinic and discharge when
appropriate
i. Provide education to medical/nursing
staff in all aspects of VAC therapy.
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life to ensure pump has power supply at
all times
remove therapy and apply conventional
dressings
with on-going support and wound
review from the expert practitioner
h. Provide information leaflet on VAC
therapy and inform competent
practitioner if further explanation
required
j. Provide patients and their carers with
explanations of VAC therapy and
provide information leaflet
j. Evaluate wound outcomes and
identify when VAC therapy dressings
need changing and when it can be
discontinued
k. Demonstrates the importance and
method of keeping accurate records of
procedures and device settings
k. Produces clear documentation
instructing medical/nursing staff
indicating therapy pressures, dressing
frequency and any potential problems
l. Liaise with Tissue Viability Team
when nursing patients with complex
wounds and complex co-morbidities
m. Liaise with Tissue Viability Team to
facilitate discharge home with VAC
therapy
n. Provide education to other nursing
staff on VAC therapy and demonstrates
ability to assess other nurses in VAC
application and theory
Education resources to support your development
Received basic training in the
functions of the VAC device from
a competent practitioner who
has achieved Level 3 or 4 or from
a Medical Devices Trainer
Read patient information leaflet
Read product information
Received training from a competent
practitioner who has achieved
competency Level 3 or 4
Attended a recognised KCI or Trust
training course or received training
from an expert practitioner
Attended a recognised KCI or Trust
training course or received training
from an expert practitioner and
assessed as competent
Received training on wound assessment
Competency maintained through
continuous professional development
http://www.kcimedical.com
Author: Barbara Topley
Control Date: 12/02/16
Department: Tissue Viability
Review Date:
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Attended a recognised KCI or Trust
training course or received training
from another expert practitioner
Assessed as competent
Competency maintained through
continuous professional development
PORTSMOUTH HOSPITALS NHS TRUST
VACCUM ASSISTED CLOSURE THERAPY GUIDELINES
MANAGEMENT OF VACUUM ASSISTED CLOSURE THERAPY. Issue 1. 28.12.2006
Record of Achievement
To verify competence please ensure that you have the appropriate level signed as a record of your achievement in the boxes below.
Level 1
Level 2
Level 3
Level 4
Date:
Date:
Date:
Date:
Signature of Assessor
Signature of Assessor
Signature of Assessor
Signature of Assessor
Print Name
Print Name
Print Name
Print Name
References to Support Competency
BANWELL P E & TEOT L (2003)
Topical negative pressure (TNP): the evolution of a novel wound therapy
Journal of Wound Care 12(1) pp22- 28
COLLIER M (2003)
Topical negative pressure
Nursing Times 99(5) pp54
KCI Medical (2003)
VAC Therapy Clinical guidelines
Oxfordshire
THOMAS S (2001)
An introduction to the use of vacuum assisted closure
World Wide Wounds
http://www.worldwidewounds.com
Control Date: 12/02/16
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