Chapter 18: Wound management
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Post‐procedural considerations
Ongoing care
It is imperative to carefully monitor the peri‐wound area for signs of infection, skin breakdown or oedema, and to check the equipment while it is in situ, to ensure patient safety. Dressings should be changed every 48–72 hours and canisters changed as required and at least weekly (Anghel and Kim [3]). The NPWT unit should not be switched off for more than 2 hours without the dressing being replaced (KCI [58]).
Discontinuing NPWT should be considered when:
- a contraindication arises
- the exudate level is less than 20 mL per day
- the wound bed presents with 100% granulation tissue that is level with the wound edges (Milne [73]).
Single‐use negative pressure wound therapy
Disposable NPWT systems provide a lightweight and portable alternative to the standard NPWT application. The same principles apply; however, disposable systems are typically applied to wounds with lesser exudate levels.
Websites
British Association of Dermatologists
British Lymphology Society
European Pressure Ulcer Advisory Panel (EPUAP)
European Wound Management Association
Healthcare Improvement Scotland: Tissue Viability
International Skin Tear Advisory Panel (ISTAP)
International Wound Infection Institute
Legs Matter
NHS Improvement: Stop the Pressure
NICE: Negative Pressure Wound Therapy for the Open Abdomen (2013)
NICE: Pressure Ulcers: Prevention and Management ([78])
NICE: Surgical Site Infections: Prevention and Treatment (2017)
Tissue Viability Society
World Wide Wounds: Dressings Datacards
Wounds UK.
