Wound Vac

I had heard about wound vacs because I had a friend that worked with them years before so after Rich's first othopedic surgery, I asked about them.  I was told that they probably would be using one, but it was a little early for that.

Within just a couple of weeks, a wound vac was put on both his ankle and left arm.  He was still at UNM at the time.  They would come in every other day and change the dressings on the wound vac and when they would, the wound would be open for us to see.  They dressed all in sanitary clothing from head to toe, they wore face masks and gloves. The dressing changes were painful, especially on the arm. When he was transferred to Kindred, the continued to do the changes, but they didn't wear their sanitary clothing.  Most of the time they wore masks and gloves, but that is it.  Is there any wonder that he got MRSA when sanitary changing of this wound vac was not a priority?

Richard can explain to you all the scientific data dealing with how a wound vac works.  I don't understand all of that, so I will explain it as I see it.  They put a sanitary sponge against the open wound and there is a tube connected to a plastic disc that sits on the sponge.  Then they put a dressing over that with the tube coming out of it.  A vacuum begins to suck on the wound at a tremendous force.  This helps the wound heal from the inside out at a much faster and safer rate than it would heal if it healed on its own from the outside in.  This machine was invented by a nurse, who I am sure is a very wealthy individual now. (As it should be.)

He had these wound vacs on both of these spots for months, and the dressings were changed every day.  They eventually took the wound vac off of the ankle, but the the arm still needed more time.  He had it on the arm for longer.

Both eventually healed, although you know by now that the bones in the arm have never healed.  (If you don't know that story, another post will tell you about it soon.) When we went to an orthopedic surgeon in about 2012, and showed him pictures of the arm, he told us that a wound vac should never be used on a bone in the condition that Richard's arm was at the time.  He said that there was no periosteum on the bone and because of that, putting that type of vacuum on the bone actually killed it instead of helping to heal it.  Of course, we had no idea that it was an issue at the time.

"The periosteum is a soft outer covering over the bone’s surface. It provides blood flow to the bone which lets a bone heal, grow, fight infection, and stay healthy. This layer is very thick in children and gets thinner as we get older." (http://noelhenley.com/four-layers-of-bone/)

Once again, the decisions of the doctors resulted in a permanant condition that we are still dealing with.

So, if you have a loved one on a wound vac, it should not look like this:

If it does, please question the use of a wound vac.  If there is a layer of covering on the bone and some tissue around the bone, you should be fine. Another indicator was that the dressing change on the ankle was mildly uncomfortable, but the dressing change on the arm felt like, (in Richard's words) someone was trying to suck his fingernails out through the wound vac. It was very painful.  He hated the dressing change on the arm.
The bottom line is that if a wound vac is used correctly, it performs miracles. I am grateful for the one on Rich's ankle, in spite of the MRSA infection.