What to know about wound VAC therapy

Several common beliefs about the wound VAC are not accurate. The pump does not heal a wound by itself. It supports a wound that also needs blood flow, nutrition, pressure relief and clean tissue. A quiet pump is not proof that all is well, since a wound can become infected under a perfect seal.

More suction is not better, and the settings are never something to adjust at home. The dressing is not meant to stay on until it falls off. It is changed on a schedule so the filler does not sit in the wound too long. And needing a wound VAC does not mean an operation failed. It is a routine way to manage a wound that needs extra help.

What the treating clinician looks at

A care plan for a wound on negative pressure therapy answers practical questions as well as clinical ones. After examining the wound, the treating clinician writes orders, and the plan around them spells out:

  • Who changes the dressing and on which days
  • Which supplier provides the pump, canisters and dressing kits
  • What the goal of therapy is and how progress will be measured
  • What to do, and whom to call, if the seal fails or the pump stops
  • When the clinician will see the wound again

Gateway’s part is to get that plan to everyone involved and to keep the visits on the calendar.

Arranging this care in North County

Many homes in North County are older single-family houses with the bedroom upstairs and the bathroom down a narrow hall. For someone carrying a pump and tubing, that layout is a fall risk, so ask the nurse about tubing length and where the pump should sit at night. Long-time residents often have a spouse of similar age as the main caregiver. That person can learn to read the pump screen and make the right phone call, and should not be expected to lift, pack or reseal a dressing alone.

Much of North County was built as subdivisions of brick ranch homes and bungalows, and those one-story houses suit home visits well. The region also has apartment complexes, senior apartment buildings, assisted living and a number of skilled nursing and rehabilitation centers. Gateway arranges partner clinician visits across all of them, from a house in Florissant to a nursing facility in Bridgeton. For a home visit, we ask where the patient is most comfortable being seen. For a facility, we ask which days work on the unit. The treating clinician handles the clinical side.

When care happens 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.

For residents of nursing and senior living communities

A resident often arrives from the hospital with therapy already running, and the first days set the tone. The hospital’s pump may not travel with the resident, so the facility needs its own unit and dressing supplies ready, with orders that match.

When a facility asks Gateway for wound follow-up, we request the hospital’s wound records and most recent measurements so the treating clinician has a baseline. After each visit, findings go to the facility’s nurses and the attending physician, who remains responsible for the resident’s overall care. Regular measurements in the chart give everyone the same evidence of whether therapy is working.

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.

Why primary care matters here

Suction cannot make up for what the bloodstream does not deliver. High blood sugar slows repair and raises infection risk, and narrowed arteries in the legs can leave a foot wound short of the oxygen it needs. If a wound on negative pressure therapy is not shrinking, the treating clinician often wants to know how diabetes is being managed and whether circulation has been tested.

Primary care is where those threads are followed: glucose records, medication review, referrals for vascular studies. Arranging both kinds of care through one coordinator means the wound clinician’s question reaches someone who can act on it.

Primary care at home in North County →

Getting care arranged in North County

You may already have a surgeon, a wound clinic or a home health nurse and still want help with wound VAC follow-up closer to home in North County. That is a fine reason to call 314-325-0126. Tell us who is treating the wound now and what is not working, whether that is the travel, the gaps between appointments or unclear instructions. Gateway does not replace your current clinicians. We can arrange for a partner clinician to see the wound where you live and, with your permission, share notes with the offices already involved so the plans agree.

North County covers many towns and ZIP codes, so start with the exact address and the municipality. Have the patient’s phone number, insurance cards and doctor’s name ready. If a relative on another street or in another town helps with care, give us that number too. Gateway arranges care in Florissant, Hazelwood, Ferguson and Bridgeton, and across the city line in North St. Louis. Because the region is spread out, each visit is confirmed by location and care setting.

  • County: St. Louis County, Missouri
  • ZIP codes: 63031, 63033, 63034, 63042, 63135, 63136, 63137, 63138, 63134
  • Nearby hospitals: Christian Hospital in North County; SSM Health DePaul Hospital in Bridgeton (not affiliated with Gateway)
  • Nearby communities: Florissant, Hazelwood, Ferguson, Bridgeton, North St. Louis
  • Care settings: Private homes, skilled nursing, assisted living, memory care and rehabilitation

More wound care in North County

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

Common questions

Who should we call in North County if the pump alarms in the middle of the night?

Use the numbers you were given at setup: the device support line printed on the pump for equipment questions, and the home health agency’s after-hours number for the dressing or the wound. In a facility, tell the nurse on duty. Gateway is not an emergency or after-hours service, though we can help afterward if a problem keeps coming back. For heavy bleeding or bright red blood in the tubing, call 911.

Why does the dressing look wrinkled and feel hard?

That is how a working dressing looks. When the pump is running and the seal is airtight, the foam under the film shrinks down and feels firm, a bit like a vacuum-packed bag. If the dressing turns soft, smooth or puffy, suction has probably been lost. Check that the pump is on and the tubing is connected, then call your nurse if it does not draw back down.

What should the fluid in the canister look like?

It varies by wound, and your clinician can tell you what to expect for yours. Often the fluid is pink or light red after surgery or a dressing change and becomes paler and more yellow with time. What matters most is change. Fluid that turns cloudy, thick or foul-smelling, or a canister that fills much faster than before, should be reported promptly. Bright red blood is an emergency, not something to watch.

Does it matter whether an address is in North County or in the City of St. Louis?

Not for requesting care. Gateway arranges visits on both sides of the city line, in North County and in North St. Louis. It does help to give the full address and ZIP code, because many North County mailing addresses say St. Louis. The exact location lets us match the patient with a partner clinician who sees people in that area.

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.