Life Can’t Be Any Easier than This—Introduction of the Portable and Disposable V.A.C. Machines

Abstract

The application of controlled levels of negative pressure on to a wound has been shown to accelerate evacuation of dead cells, debris and fluid which eventually encourages wound healing in a verity of surgical wounds. Vacuum Assisted Closure (V.A.C.) therapy-KCI Medical Limited, the terminology by which this is widely known, became popular, especially among the plastic surgery professionals in America and soon gained recognition worldwide. It is now widely used in the UK to manage and assist healing in a wide variety of wounds. Although KCI's V.A.C. machines were the only ones on the market for a number of years, several wound management companies have now brought out their own machines and these are now known collectively as topical negative pressure therapy (TNPT). Traditional TNPT is often considered a relatively costly procedure. It is often used in patients with large wounds to facilitate dressing management and promote rapid cleaning and granulation. This may also allow them to be discharged to the community when they would otherwise remain inpatients, thereby saving bed days. Capital purchase of the machines is expensive and hospitals often rent or lease them on a short or long term basis. This can lead to difficulties in arranging the finances for discharge to the community. Subsequent dressing changes (recommended every 48 -72 hrs) also incur high costs and involvement of the trained medical or nursing staff. As we all know; "Need is the mother of invention". The disposable TNPT machine (V.A.C. Via™, KCI Medical Ltd.) has been introduced to help to solve these problems. It is a single use machine, inclusive of a dressing and canister and available off the shelf. It is very cost effective, easy to use and is used for small to moderate sized wounds. Senior author is using this machine which excellent results and illustrated the use of this machine with pictures in this paper.

Using portable negative pressure wound therapy devices in the home care setting

“…This is mainly for dressing changes, but also to check that their device usage is appropriate. 1 Patients require an adequate knowledge and understanding in order to be comfortable with handling their device at home; complications may be overlooked without this. This incurs an additional cost and need for trained staff.…”

“…Initial purchase costs of nonportable NPWT machines are around £15,000/US $25,000, not including dressing and canister costs at around £20/US $35 each. 1 Costs of portable NPWT systems are much less. The VAC Via TM system costs £260/US $450 (including charger, carry bag, dressing kit, canister, and adhesive drapes), and the PICO system costs £120/US $200 (including one battery pack and two dressings).…”

“…The VAC Via TM system costs £260/US $450 (including charger, carry bag, dressing kit, canister, and adhesive drapes), and the PICO system costs £120/US $200 (including one battery pack and two dressings). 1,35 Such portable systems are more cost effective than their inpatient counterparts, even when the expense of hospital bed days is excluded. Indeed, two studies have estimated a saving of around US $8,500 for each patient treated with home care NPWT compared with normal wound dressing hospital care.…”

“…59 There may be a disadvantage in the need to carry the portable pump, although reports show that pumps are small enough to conceal and do not interfere with daily life. 1,9,12 Difficulty of use can be avoided with proper patient counseling given before discharge with portable NPWT. Additionally, as dressing changes require regular visits from a health care professional, these can also be utilized to consolidate the patients' understanding of the device.…”

“…These terms are used interchangeably within the literature. 1 First documented in 1993 by Fleischmann et al, 2 this wound therapy modality is a popular treatment option today for both acute and chronic wounds. 3 Its use has been described in recalcitrant wounds such as pressure sores, 4,5 radiation ulcers, 6 degloving injuries, 7 and a wide variety of wounds with acute or chronic infection.…”