Acelity V.A.C.ULTA Mode D'emploi page 11

Continuous versus DPC (Dynamic Pressure Control) V.A.C.® Therapy: Continuous V�A�C�® Therapy
is recommended over unstable structures, such as an unstable chest wall or non-intact fascia, in order
to help minimize movement and stabilize the wound bed� Continuous therapy is also generally
recommended for patients at increased risk of bleeding, highly exudating wounds, fresh flaps and grafts,
and wounds with acute enteric fistulae.
NOTE: V.A.C. VeraFlo™ Therapy, due to the controlled delivery of wound irrigation
and treatment solutions, provides intermittent V.A.C.® Therapy and is not
recommended in the above wound types or conditions.
Patient Size and Weight: The size and weight of the patient should be considered when prescribing
V�A�C�® Therapy or V�A�C� VeraFlo™ Therapy� Infants, children, certain small adults and elderly patients
should be closely monitored for fluid loss and dehydration� Also, patients with highly exudating wounds
or large wounds in relation to the patient size and weight should be closely monitored, as they have a risk
of excessive fluid loss and dehydration� When monitoring fluid output, consider the volume of fluid in
both the tubing and canister�
Spinal Cord Injury (SCI): In the event an SCI patient experiences autonomic dysreflexia (sudden
changes in blood pressure or heart rate in response to stimulation of the sympathetic nervous system),
discontinue V�A�C�® Therapy or V�A�C� VeraFlo™ Therapy to help minimize sensory stimulation and seek
immediate medical assistance�
Bradycardia: To minimize the risk of bradycardia, V�A�C�® Therapy and V�A�C� VeraFlo™ Therapy must not
be placed in proximity to the vagus nerve�
Enteric Fistulas: Wounds with enteric fistulas require special precautions to optimize V�A�C�® Therapy�
Refer to V�A�C�® Therapy Clinical Guidelines for more detail� V�A�C�® Therapy is not recommended if enteric
fistula effluent management or containment is the sole goal of therapy�
NOTE: V.A.C. VeraFlo™ Therapy should not be used in the presence of enteric fistula to
prevent wound contamination.
Protect Periwound Skin: Consider use of a skin preparation product to protect periwound skin� Do
not allow foam to overlap onto intact skin� Protect fragile / friable periwound skin with additional drape,
skin protectant, hydrocolloid, or other transparent film� Multiple layers of the drape may decrease the
moisture vapor transmission rate, which may increase the risk of maceration� If any signs of irritation or
sensitivity to the drape, foam, or tubing assembly appear, discontinue use and consult a physician� To
avoid trauma to the periwound skin, do not pull or stretch the drape over the foam dressing during
drape application� Extra caution should be used for patients with neuropathic etiologies or circulatory
compromise�
Circumferential Dressing Application: Avoid use of circumferential dressings except in the presence
of anasarca or excessively weeping extremities, where a circumferential drape technique may be
necessary to establish and maintain a seal� Consider using multiple small pieces of drape rather than
one continuous piece to minimize the risk of decreased distal circulation� Extreme care should be taken
not to stretch or pull the drape when securing it, but let it attach loosely and stabilize the edges with an
elastic wrap, if necessary� When using circumferential drape applications, it is crucial to systematically
and recurrently palpate distal pulses, and assess distal circulatory status� If circulatory compromise is
suspected, discontinue therapy, remove dressing, and contact a physician�
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