Wound Vacuum Devices

One common treatment for pressure sores is negative pressure wound therapy. This is the use of a vacuum device that creates a gentle suction on the wound. The wound vac draws drainage out of the wound, keeping it clean. It also draws blood to the wound, and blood flow is important for wound healing. This is an effective treatment that has been used for years to heal wounds.

The company that developed this therapy is Kenetic Concepts Inc., better known simply as KCI. Their name for the treatment is V.A.C. Therapy (see the link on the right under "Recommended Treatments"). KCI patented this technology, and for years was the only company offering wound vac devices. The patent expired recently, and now other companies are entering the field. Most notable among the newcomers is Smith & Nephew, which offers their Renasys Negative Pressure Wound Therapy devices (see link in "Recommended Treatments).

My wound was deemed too small for the KCI device, so I was treated using the Renasys vac. I have no doubt that this device is useful in treating wounds, but it did not help in my case. The visiting nurses I had treating me had many years of experience with the KCI devices, but had never used the Smith & Nephew ones before. There is enough of a difference in the dressings the two systems use to matter. So the nurses applying the dressing were doing so for the first time. That, plus the fact that I did not have the same nurses consistently, led to the failure of the device to help me, in my opinion. I have come to learn that applying the dressings for wound vacs is as much an art as a science, and my nurses were not experts in either.

So once again, the wound did not heal. It did not get worse, but it didn't get better, either. Sound familiar? It sure did to me. By now 4 months had gone by since I went on short term disability, and I was in the same basic condition I was when I started.

But now it gets even more interesting. I start getting a fever. At first I hope it is a urinary tract infection, because I can kick those pretty easily. But after a few days of eating cipro antibiotics, the fever gets worse. The only thing it can be is the wound. I have no choice; I go to the emergency room of the Small Town Hospital where the wound care center I've been using has their offices.

You think this has been fun so far? Just wait - the Follies are just getting started!

Let's Get Serious!

Now I'm on short term disability so I can spend more time in bed, off my butt. Plus I get home nursing care coming to my house every two days to treat my wound and change the dressing on it. I'm told the wound is small and healthy looking. So the wound should heal quickly now, in a matter of a few weeks, right? Wrong! We wouldn't have any Wound Care Follies if that happened, would we?

For a couple of months the nurses treat the wound with a packing material that is supposed to prevent infection and promote healing. I spend some time out of bed, in my wheelchair, but I try to stay down, off my butt as much as possible. I probably could have done a better job of that, looking back. It was too easy to "cheat", to stay up in the wheelchair longer than I should have. Plus, hours often went by without my noticing, as I got immersed in whatever I might have been doing. At any rate, the wound did not respond. It didn't get worse, it didn't get better. Just like before. So my wound care doctor decides try something else. We are going to try a wound vac device.

The Early Days

Wounds can be sneaky.  Wounds that look minor can become serious quickly.  They can develop out of nowhere fast, too.  I heard of one hospital patient who developed a pressure sore after only 3 days in the hospital. 

My wound did not become problematic very quickly, however.  I fooled around with it for a while before it got larger and deeper.  I used DuoDerm (see the Amazon link on the right side of this page) on the wound for a few weeks. It had always healed my superficial wounds in the past, so I thought it would again.  It is a fine product for wound management, one I would recommend in a heartbeat.  People who are prone to getting superficial wounds should always have a few sheets on hand.  But this time it didn't work for me. After realizing that I needed more help with this pressure sore, I went to a Big City Hospital to see the wound care people there.  They recommended some ointments to put on the wound, and told me to stay off my butt as much as I could.  That didn't work, either - the ointments did nothing, and I wasn't very good at spending much time out of my wheelchair, either.  I was working a full-time job at the time, so I didn't have much opportunity to lay down during the day. 

The people I saw at Big City Hospital weren't very aggressive in treating the wound, in my opinion.  So I gave up on them, and started going to a wound care center at my local Small Town Hospital.  I had great confidence in them; they seemed to know what they were doing, and had a plan for me to get rid of the wound.  I tried their treatments for quite a while, and...nothing.  I was spending less time in the wheelchair, and following their directions carefully. The problem was, the wound wasn't getting worse, but it wasn't getting better, either.  Frustration set in.  What do I do now?

By this time roughly 6 months had gone by since I first noticed the sore.  OK, time to get serious.  I talked to the doctor at the wound care center, and we agreed that I needed to go on short term disability from my job so I could spend even less time in my wheelchair, and also to get home nursing care to dress the wound every two days.  I'm sure I will get rid of the wound pretty fast now!

The Beginnng

How do pressure sores start?  There are many ways.  For wheelchair users sores are most common on the buttocks.  Sitting too long without taking breaks can cause them.  So can "bad" transfers, where the skin might be affected by an abrasion or more severe impact when moving to or from the wheelchair. Diabetics can have decreased blood flow to their extremities, which can make breakdown  possible in the feet and legs.  Bedridden people can develop sores on their feet or buttocks from laying in one position too long, or from laying on mattresses that don't provide good skin protection.  Every one's skin becomes thinner as we age, too, making us  more susceptible to breakdown.

In my case, I'm pretty sure that a rash on my rear end started the process.  I hate to admit it, but I was at fault.  I picked at the skin that was peeling away, and I believe I picked some live skin away with some dead skin that was flaking off.  Something as simple as that started the whole process...