James is a healthy 32 year old gentleman, who is active and cognitively intact the latter contributes to his ability to manage this therapy at home. James along with professional support will monitor his wound care to achieve a healed wound. The immediate benefits of this choice in wound care are the facilitation of his early discharge from hospital and the VAC therapy will assist in the promotion of blood supply to the wound bed allowing for formation of granulation tissue . Using this system will allow him to continue working due to the portability of the system. James will be able to maintain his socially active lifestyle with some limitations. “There is a substantial body of clinical and economic evidence supporting NPWT in wound management, including early discharge and faster healing, fewer readmissions and better patients’ Quality of life” (Othman, 2012) With pre discharge education regarding this system and ongoing support from trained staff the VAC system will ensure optimum benefits are achieved. The final outcome and goal to be achieved is a healed wound in a reduced timeframe. The VAC dressing would remain in place for 3- 7 days depending on the exudate present and the adherence of the dressing. This allows for longer times between dressing changes. James will play an active part in his care by monitoring the site regularly in partnership with the community nursing services. The wound care and his wellbeing will be assessed regularly. A holistic assessment on commencement of the therapy and regular ongoing assessments during its use will ensure James receives and optimum level of care based on evidence based practice. * NPWT is Negative pressure wound therapy it uses a vacuum dressing to boost and promote wound healing in acute and chronic wounds. “Negative pressure (suction) is applied to the wound bed through a foam or gauze contact medium using an electrically, battery or mechanically powered pump; this involves achieving an airtight, vacuum, seal.” (Guy & Grothier, 2012) Subsequently, James was referred to a plastic surgeon for reconstructive surgery. The surgeon performed a myoocutaneous rotation flap using muscle and tissue from nearby areas. Postoperatively, the surgeon opted to used negative pressure wound therapy (TNPT) using a VAC system.
Indications for use for James,
* As James’s wound site is unable to be closed surgically the negative wound pressure therapy will promote and expedite his healing, it allows for increases in local blood flow, reduction in oedema, stimulates the formation of granulation tissue, stimulates cell proliferation and removes soluble healing inhibitors from the wound, “provide e!ective local infection control”. (Rycerz , Vowden , Warner & Jørgensen B. , 2012) as this is a closed system. It also allows for wound edges to be drawn closer together.
* NPWT is an effective exudate management option for highly exuding wounds, particularly for postoperative incision management . In James’s case the non closure of his wound. * negative pressure wound therapy has economic benefits in acute wound care these benefits include the economic impact of delayed wound healing on the national health budget. * this system will allow James to continue to work and remain socially active enabling him to achieve a positive influence on is quality of life. James’s age makes this system suitable for at home use and with support of the visiting home care service this should prove successful in treating his current wound. Disadvantages for its use
* “Possible disadvantages of NPWT include some pain sensation on treatment, a risk of developing pressure ulcers in the areas treated, and the relative expense of the treatment, particularly over a short time frame” (Swezey, 2011) * “This survey confirms that pain is a major problem in wound management, irrespective of the...
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