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Negative Pressure Wound Therapy

Wounds in pediatric cancer patients need extra care. Cancer and cancer treatments can slow the healing process. Infection and other complications may occur. One method commonly used to help wound healing is wound vac or negative pressure wound therapy. This procedure may also be known as V.A.C.® Therapy or vacuum-assisted closure. It may be used on new wounds, older wounds that have not healed, or surgical incisions.

How wound vac therapy helps healing

Wound vac involves placing a dressing over the wound and applying suction. The suction may be continuous or may run on a cycle. The suction does several things that are important for wound healing:

  • Removes fluid from the wound
  • Reduces swelling in the area
  • Helps the edges of the wound come together
  • Increases blood flow

Steps of wound vac therapy

In some cases, the wound vac dressing may be applied or changed under sedation or general anesthesia.

  • The wound is cleaned, and the skin around the wound is cleaned. A mesh or contact layer may be placed over the wound site.
  • Next, a piece foam dressing in the shape of the wound is applied over the site.
  • A clear adhesive film, or drape, is placed over the area to provide a seal.
  • A vacuum tube is placed over the foam.
  • The tube is connected to the small portable suction pump and power turned on.  

What to expect during wound vac therapy

When the pump is turned on, suction removes air from the site. The dressing will collapse, and you may feel a slight pull. Fluid will be pulled from the wound and pass through the tube where it collects into a canister attached to the pump.

For most patients, wound vac does not cause added pain. When the suction starts, it might create a slight pulling sensation, but the feeling usually goes away after a few minutes. As the wound heals, the area may be itchy or uncomfortable.

Let your doctor know if pain or discomfort increase or there are signs of infection should as increased redness, swelling, or fever.

Your care team will teach you basic operation of the pump. Alarms will sound to notify you of common issues such as loss of suction, low battery, or a full canister.

The pump stays turned on until the dressing change. The dressing and tubing are usually changed at least once a week (or more often depending on wound characteristics). Your care team can recommend medication and other ways to manage pain during dressing changes.

The overall duration of wound vac therapy varies widely based on patient needs. Some patients may have the therapy for a few days. Other patients may need wound vac therapy for months.

Portable wound vac therapy systems allow patients to do most normal activities within the limits set by the care team. Patients can shower by clamping the tubing and removing the pump unit for a short period of time.

Advantages of wound vac

  • Helps the healing process
  • Less frequent dressing changes
  • Dressing stays in position and does not shift as easily with movement
  • Better protection of the wound and surrounding skin

Disadvantages of wound vac

  • The portable pump may be inconvenient to carry or maintain
  • Dressing changes can be painful, but discomfort is similar to other wound care procedures
  • Wound vac is not appropriate for all patients
  • The system can be expensive; insurance may have certain requirements for coverage

Tips and troubleshooting

Families should consult their user manuals for help for the specific system they use for wound vac therapy. However, here are some general tips and hints for troubleshooting at home.

Most at-home wound vac therapy units have these main parts:

  • Therapy unit (pump)
  • Canister or absorbent layer for fluid collection
  • Attachment pad and tubing
  • Foam dressing or silicone layer
  • Adhesive protective layer (clear waterproof drape)

Family caregivers should check the device often and make sure that:

  • The pump is turned on
  • The foam dressing is collapsed
  • No air is leaking from the drape or tubing
  • The battery is charged

The therapy unit will sound a beep or an alarm if there is a problem. The care team will explain how to use the system, but most alarms are due to one of the following reasons: therapy is not active, the battery is low, there is a leak, or the canister is full and needs to be changed.

A full canister is usually changed in the clinic by the care team. However, a family caregiver may be taught how to remove and replace the canister if needed. Caregivers will also be taught how to repair leaks in the drape.

Contact your care team

Call your doctor if any of the following occur:

  • The fluid in the canister looks different in color or consistency
  • Bleeding increases
  • Pain, redness, or odor increase
  • The system is off for more than 2 hours

does not endorse any branded product mentioned in this article.

Reviewed: June 2018