What a wound VAC is
Negative pressure wound therapy, often called a wound VAC or NPWT, uses gentle suction to help certain wounds heal. A piece of foam or gauze is fitted into the wound and covered with a clear film to make an airtight seal. Tubing connects the dressing to a small pump, which draws wound fluid into a canister.
Wound VAC and negative pressure wound therapy follow-up in St. Louis covers what keeps the therapy working after it is ordered: clinician visits, dressing changes, supplies and answers when something goes wrong. A clinician orders the therapy for a specific wound, such as a surgical incision that has opened, a deep pressure injury or a foot wound after surgery. It is not right for every wound, as our guide to what negative pressure wound therapy is explains.
If you are looking for help with this wound close to home, start with our overview of wound care in St. Louis.
Why wounds on negative pressure therapy take time
The wounds chosen for this therapy are usually large, deep or draining heavily, so they start with a long way to go. The therapy also works only while the seal holds and the pump runs. Common interruptions include:
- Air leaks where the film lifts over a skin fold, a damp area or a joint that moves
- A full canister, kinked tubing or an uncharged battery
- Supplies that run out before the next delivery
- Pain at dressing changes that leads to changes being put off
What the treating clinician considers
The therapy runs on a clinician’s order, which sets the pump settings and the dressing change schedule. At follow-up visits the treating clinician typically reviews:
- Wound size and depth compared with the last visit
- Dead tissue or tunneling in the wound
- The amount and color of fluid in the canister
- Signs of infection
- The skin under and around the film
- Bleeding risk, including any blood thinners you take
- Whether the therapy is still helping and when to switch to another dressing
The clinician also decides when the therapy stops. Gateway handles the coordination behind wound VAC therapy at home.
Wound VAC follow-up at home and in facilities
At home, home health nurses often change the dressing on the ordered schedule, a medical equipment supplier provides the pump and supplies, and the treating clinician sees the wound and updates the orders. Gateway coordinates wound care alongside home health and tracks supplies and equipment orders, so one missing piece does not stall the therapy.
In skilled nursing and rehabilitation, facility nurses change the dressing and answer alarms. The treating clinician works with them so every shift knows what to do if the seal fails. Before a resident goes home with a pump, the plan should name who will change the dressing, where supplies will come from and whom to call after hours.
How primary care factors in
A heavily draining wound loses protein and fluid, so eating and drinking enough takes on more importance. A primary care clinician can also follow blood sugar, review medicines and help with pain and comfort.
If you take a blood thinner, the wound clinician needs to know. Do not stop or change it on your own.
Changes to report and when to call 911
Bright red blood filling the tubing or canister is an emergency. Call 911 and follow the emergency instructions that came with the device.
Report these promptly to the nurse or treating clinician:
- An alarm that will not clear, or a pump that will not stay on
- A dressing that has gone soft or puffy, or a seal that keeps leaking
- A canister filling much faster than usual, or fluid that turns cloudy, thick or foul-smelling
- Fever, chills, spreading redness or increasing pain
- Blisters, rash or soreness under the film
Ask in advance how long the pump can safely be off and what to do if that time passes. Our guide to wound VAC problems covers the common ones.
How Gateway helps arrange follow-up
Patients and families can call 314-325-0126, with or without a referral, or request a callback. The form is for contact details only. Hospitals, surgeons, home health agencies and facilities can refer a patient online or by fax at 314-786-7966.
We gather the current orders and wound records, confirm who is changing the dressing and who supplies the equipment, and schedule visits with a partner clinician. Visit availability is confirmed by location and care setting across Greater St. Louis and the Metro East. Gateway is not an emergency service and does not replace the support line for your device.
Common questions
What should I do when the wound VAC alarm goes off?
Start with the screen, since most pumps name the problem, such as a leak, a full canister, a blockage or a low battery. Check that the tubing is not kinked or clamped and that the canister is seated. If the alarm will not clear, call your nurse or the support number on the device. Do not remove the dressing unless you were taught when and how.
Who changes the wound VAC dressing?
A trained nurse or clinician does. At home that is usually a home health nurse, and in a facility it is the nursing staff. Family members are generally not expected to change this dressing, though you may be taught what to do if the seal fails.
How long will I need the wound VAC?
There is no set length. The treating clinician reassesses the wound regularly and continues therapy while it is making measurable progress toward a goal, such as a wound shallow enough for ordinary dressings or ready for surgical closure. Ask what the goal is for your wound and how progress is measured.
Can I shower or leave the house with a wound VAC?
Portable pumps are made to go with you in a carrying case, and many people leave home with one. Showering depends on your orders and your device, and the pump itself must stay dry. Ask your nurse or clinician before you try.
Related pages
General information to help you talk with your own clinician. It is not medical advice, and the treating clinician makes every clinical decision. For a medical emergency, call 911.