What to know about wound VAC therapy

Negative pressure wound therapy, which most people call a wound VAC, is a way of dressing a wound that uses controlled suction. A foam or gauze filler is placed in the wound and sealed under a thin, clear film. Tubing runs from that sealed dressing to a portable pump, and the fluid the wound produces collects in a canister attached to it.

The suction is steady and gentle, not strong. Its job is to move fluid away from the wound, protect the wound bed between dressing changes and draw the edges toward each other. A clinician orders the therapy and sets how the pump runs. It is a treatment tool with a beginning and an end, not a permanent device.

How the care plan is built

The treating clinician looks past the wound to the person wearing the device. Is pain at dressing changes controlled well enough that changes happen on time? Can the person walk safely with the tubing, sleep, and keep the pump charged? Is a bed, chair or shoe pressing on the wound in a way suction cannot overcome? These answers count as much as the measurements.

The clinician also plans the exit early: what the wound should look like when the pump comes off, what dressing will replace it and whether a surgeon will close or graft the wound. Knowing the end point helps everyone judge whether each visit shows movement toward it.

Arranging this care in Alton

On the Illinois side of the river, the details behind a wound VAC can differ from Missouri. Home health agencies are licensed by state, the equipment supplier has to serve Illinois addresses, and Illinois Medicaid and Illinois-based health plans have their own rules for authorizing a pump and its supplies. Before follow-up is scheduled in Alton, Gateway confirms which treating provider can see you there and how that provider works with your plan. We do not assume that an arrangement made for a Missouri patient carries over.

Much of the housing in Alton is older: large houses in the historic districts, frame houses on narrow lots, apartments in converted buildings and newer homes farther from the river. Many front doors are reached by a long flight of steps. The city and its neighbors also have senior apartments, assisted living, and skilled nursing and rehabilitation centers. Gateway arranges visits from partner clinicians in every one of these settings. We ask about steps, entrances and parking ahead of time, and in facilities we coordinate the visit and the resulting orders with nursing staff.

Care at home

Supplies are the piece most likely to interrupt therapy at home. Dressing kits and canisters are matched to the pump and to the wound, so a substitute from a drugstore will not work. Gateway follows up with the supplier when the clinician’s order changes, for example when the wound shrinks and a smaller dressing kit is needed.

It helps to keep the boxes together in one dry place and to tell the nurse when only a few changes’ worth are left. Running out on a Friday is far harder to fix than reordering early in the week.

In a facility

Assisted living and memory care communities often do not have nurses who change negative pressure dressings, so a home health agency usually comes in for that, much as it would in a private home. Staff still need the basics: what the alarms mean, where the tubing should sit and who gets the call.

In memory care, a resident may tug at the tubing, peel the film or forget the pump when standing up. The treating clinician weighs that honestly and sometimes decides a different dressing is safer. Gateway keeps the community’s staff, the agency, the family and the clinician working from one current set of orders.

What to report and when to call 911

Some problems belong to the device, and they still deserve a prompt call to the nurse or treating clinician, because a pump that is off has stopped helping:

  • An alarm that keeps returning after the tubing and canister have been checked
  • A dressing that is no longer firm and drawn down
  • A hissing sound, or a film edge that will not stay stuck
  • A pump that will not charge or turn on
  • Fluid leaking from under the film

Bleeding is different. If bright red blood is filling the tubing or canister, call 911 and follow the emergency steps in the instructions that came with the pump.

How primary care fits in

Most people on a wound VAC are also recovering from a hospital stay, and the wound is only one part of that recovery. Being tethered to a pump can make people move less, sleep badly and feel discouraged, and moving less brings its own risks, from weakness to new pressure injuries.

Primary care looks after that wider picture: strength and fall risk, bowel and bladder problems that threaten the seal, mood, and follow-up with the surgeon. When Gateway arranges wound care and primary care together, visits can be planned around each other and the family has fewer separate offices to keep track of.

Primary care at home in Alton →

How to get started in Alton

Clinicians and facility staff referring a patient for wound VAC follow-up in Alton can call 314-325-0126 or fax 314-786-7966. Helpful to include: demographics and insurance, the working diagnosis, recent wound notes and measurements, current orders, the medication list and relevant test results. Please also tell us who should receive the treating clinician’s notes afterward. The online referral form takes contact details only, so clinical records should come by fax, not through the form. Gateway confirms that the referral arrived, checks availability for the patient’s address and lets your office know what has been scheduled.

When you call about care in Alton, mention right away that the address is in Illinois, and have the 62002 ZIP code, a phone number, the regular doctor and the insurance card on hand. Insurance plans and provider participation can differ on each side of the state line, so we check before scheduling. Availability is confirmed by location and care setting. Gateway also arranges care in Godfrey, the rest of the Riverbend, Edwardsville and elsewhere in Madison County.

More wound care in Alton

Read the full guide to wound VAC therapy, or see everything Gateway arranges on the mobile wound care in Alton page.

Common questions

My parent is being discharged to Alton with a wound VAC. What should be in place first?

Ask the discharge planner four things: which home health agency will change the dressing and on what days, which supplier is sending the home pump and when it arrives, who will follow the wound after discharge, and whom to call after hours. Get the current orders and latest measurements in writing. Gateway can help arrange follow-up with a partner clinician and gather those records. Call 314-325-0126.

What happens if the power goes out while I am on a wound VAC?

Portable pumps run on a rechargeable battery, so a short outage is usually not a problem if the pump has been kept charged. Check your device instructions for how long the battery lasts, and plug the pump in whenever you are resting. If it will be off longer than your instructions allow, call the nurse or the number your clinician gave you and ask what should be done with the dressing.

Can I sleep normally with a wound VAC?

Most people do, with a little setup. Put the pump on a stable surface where your instructions say it should sit, plug it in so it charges overnight, and route the tubing so you will not lie on it or catch it when you turn. If the wound is over the tailbone or hip, ask the clinician which positions to avoid. Tell the nurse if alarms keep waking you, since a recurring leak can often be fixed.

What kinds of wounds can be seen at home in Alton?

Partner wound care clinicians commonly see pressure injuries, diabetic foot ulcers, venous and arterial leg ulcers, surgical wounds that are slow to close, and skin tears. The treating clinician assesses the wound and decides whether care at home is appropriate or whether a hospital or clinic setting is needed. Call 911 for heavy bleeding or for fever with confusion.

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.