company news about Efficacy observation and care after VSD negative pressure drainage

Negative pressure closed drainage (VSD) is a new drainage technique with a unique design that provides significant improvements in surgical drainage techniques. It is the application of semi-permeable adhesive film to close the wound, greatly reducing the chance of infection, with the help of medical foam to turn the traditional point-like drainage into surface drainage, which not only expands the drainage area but also solves the problem of drainage obstruction, can completely remove the secretion and necrotic tissue of the cavity or wound, and promote the healing of the wound. Compared with traditional drainage methods, VSD technology has efficient and thorough drainage; Faster wound convergence and shorter healing time; The continuous negative pressure state stimulates capillary hyperplasia and promotes the neat, rapid and uniform growth of granulation tissue; Convenient observation and nursing to reduce the burden on medical staff; Effectively prevent cross-infection and other advantages. Since the application of this technology in 2011, our hospital has admitted 9 related cases, and the wound healing is satisfactory, the hospitalization period of patients has been greatly shortened, and the clinical effect is remarkable. The nursing experience is summarized below.
1 Information and methods
1.1 General Information During January 2011 --- December 2011, a total of 9 patients were admitted, including 6 males and 3 females, aged 34~66 years old, the average age was 45 years old, 6 cases of skin defects, 3 cases of bedsores, and the length of hospital stay was 13~50 days, with an average of 24 days.
1.2 Treatment method All 9 patients first completely removed the inactivated tissue, pus and foreign bodies in the wound and space, cleaned the wound skin, designed and covered VSD material, connected the negative pressure source, sealed the wound, and gave continuous negative pressure drainage.
1.3 Results After 9 patients were treated with VSD, the wound recovered well, and there were no complications of infection and necrosis.
2 Care
2.1 Usual care. Change the patient's position frequently, raise and suspend it with gaskets and quilts to prevent the drainage tube of VSD material from being compressed or folded, thereby blocking the negative pressure source. Choose a transparent drainage bag and change it once a day. When replacing the drainage bag, in order to prevent the liquid in the drainage tube from flowing back into the VSD material, clamp the drainage tube first, close the negative pressure source, and then replace the drainage bag.
2.2 VSD related care.
2.2.1 Observation points during the use of VSD: whether the negative pressure of the negative pressure source is within the specified range: -125mmhg~-450mmhg (-0.017Mpa-0.06Mpa), whether the VSD material collapses, whether the drainage tube tube shape exists and whether a large amount of fresh blood is sucked out.
2.2.2 negative pressure maintenance time, a negative pressure seal drainage can maintain effective 5~7 days, generally after 7 days to remove or replace, larger area of damage can be VSD1~2 times, the time is 7~15 days, for large-scale bone exposed injury, the surrounding granulation tissue crawling speed is slow VSD method 3~4 times, depending on the specific situation.

2.2.3 Special Situation Handling
(1) The dry knot of VSD dressing becomes hard, which may be due to dealcoholization and hardening of VSD material caused by poor sealing and air leakage, or because the wound liquid drainage is attracted clean. If it becomes hard in the first 48 hours, you can slowly inject normal saline from the drainage tube, soak the VSD dressing to make it soft again, and then turn on the negative pressure again, carefully check the seal inaccuracy, and sometimes find the location of the leak by the air leakage sound heard when close to the dressing, the most common air leakage sites are: drainage tube or San's fixation nail, the mesangium, the connection of the tee joint, the edge of the liquid exudation, the skin crease, disordered film leads to a "leakage gap" between the membrane. Treatment: reseal the air leakage; If it hardens after 48 hours and there is no continuous flow of drainage in the drainage tube, it can be left untreated and generally does not affect the final effect of VSD.
(2) The drainage pipe is blocked
Sometimes it can be seen that there is a section of dried drainage in the drainage tube to block the lumen of the tube, and thus cut off the negative pressure source of VSD material, and even make the material bulge, no tube, you can use sterilization injection 10~20ml to flush the suction pipe.
(3) The VSD material is bulging and the tube shape cannot be seen. In addition to the blockage of the drainage tube, the common cause should also consider the abnormal negative pressure source, air leakage at the joint of the drainage channel, the drainage tube is compressed by the patient's weight, folded, etc., at this time, it needs to be treated according to the cause.
(4) S&N translucent film patch within 15 days, will not cause folliculitis, dermatitis, the state for this membrane to allow water vapor and air through.
(5) VSD dressing has a little necrotic tissue and exudate residue, sometimes through the semi-permeable membrane to emit a foul smell, and even VSD dressing appears yellow-green, green-pus-color, gray-dark and other dirty colors, which is not caused by the necrotic tissue of the wound, will not affect the treatment effect of VSD, generally do not need to do special treatment.
(6) When a large amount of fresh blood is sucked out, the doctor on duty should be notified immediately, carefully check whether the wound has active bleeding, and make corresponding correct treatment.
2.3 Prevention Programs.
2.3.1 Remind the surgeon to operate meticulously, debride thoroughly, stop bleeding completely, and minimize wound bleeding; Try to avoid air leakage when applying the film.
2.3.2 Remind patients or accompanying personnel to try not to touch, press, fold drainage tubes, cherish and maintain negative pressure drainage equipment and other related precautions.
2.3.3 Always have some small parts, such as S&N translucent film, tee joint, etc., which can be replaced by themselves if necessary.
3 Summary
Through clinical application and observation, it can be seen that VSD technology not only excellently implements the principle of changing open wounds into closed wounds when dealing with wounds, isolating the wound from the outside world, greatly reducing the external influence of pollution, controlling bacterial infection, but also being breathable, all-round continuous drainage, so that the exudate, necrotic tissue, etc. of the wound are discharged in time, replacing the traditional repeated debridement and dressing change, which significantly reduces the pain caused by daily dressing changes to patients, and greatly reduces the work intensity of medical staff.