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A case study showing the improvement in a patient with a large abdominal wound using V.A.C. Veraflo technology

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A Case Study Showing Improvement in a Patient With a Large Abdominal Wound Using V.A.C. VeraFlo™

Mr. Amir Botros, MBBCH, MRCS,

Ms. Paula Curran, Tissue Viability CNS – [email protected]

South Tipperary General Hospital, Clonmel, Co. Tipperary, Ireland

Introduction

During  negative pressure wound therapy with instillation (NPWTi), a topical solution is slowly introduced into the wound bed and resides for a planned interval of time before removal during a cycle of NPWT. The therapy is intended to deliver an automated cleansing of the wound bed and extraction of infectious materials and debris.

We present a case study evaluating the use of V.A.C. VeraFlo™ (NPWTi) on a large abdominal wound following repair of an incarcerated parastomal hernia, with mesh present. The patient underwent surgery for repair of incarcerated parastomal hernia, with 2.2metres of gangrenous bowel removed.  The abdominal defect was closed with a mesh applied and fixed by tucker and stitches.  The skin was closed with skin clips with two drains left insitu. 

Method

Wound was reviewed 10 days post operatively, clip were insitu with dehiscence to mid incision line and large exudates from wound noted.  Medial clips were removed. Incision line 23cm in length, wound 9.8cmX4.2CM, wound bed sloughy with subcutaneous fat noted.  An antimicrobial dressing was used as a primary dressing with an absorbent secondary dressing. 

Wound assessment identified that , given the size, exudate, management and condition of the patient ‘s wound, that V.A.C. VeraFlo™ would be the most appropriate option with a saline solution to be used for instillation.  A wound management plan was then devised and communicated to all team members.  The team were given training and support by the Acelity Territory Manager in the application of the dressing for continuity of the patient’s management. 

Results

The wound dramatically changed in size and shape following the use of V.A.C. VeraFlo™.  Wound dimensions were documented weekly.  The wound initially measured 20cm x 23cm x 5cm and reduced to 9cm x 5cm x 1.6cm over a 7 week period.    This equates to a 94% reduction in wound size. There was a significant reduction in fluid required for instillation and also in exudate levels.

Discussion

V.A.C. VeraFlo™ assisted in the achievement of the wound now being 95% granulation tissue.  The patient expressed that her pain was greatly reduced.  The exduate levels and fluid required for instillation reduced dramatically. V.A.C. VeraFlo™ therapy was used for a 7 week period and was then changed to  ActiV.A.C.® therapy. This allowed for the patient to mobilise more freely and independently and also assisted with the discharge planning process.  The wound has continued to improve on  ActiV.A.C.® therapy.

Conclusion

Overall, the V.A.C. VeraFlo™ achieved excellent outcomes with regard to wound management. Following education and support it was easy to apply and the patient found that the dressing supported her abdomen and ensured patient comfort and reassurance

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