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V.A.C.® Therapy Treatment Guidelines

Remove exudate and infectious materials for effective wound healing

V.A.C. Therapy recommended guidelines for lower extremity ulcers

Aims and objectives of Vacuum-Assisted Closure Therapy:

  • Stimulate granulation tissue formation
  • Provide a closed, moist wound environment
  • Remove exudate and infectious materials
  • Precondition wound for (surgical) closure
Recommended settings for lower extremity ulcers – treatment
Initial cycle Subsequent cycle Target pressure V.A.C.® GranuFoam™ Target pressure V.A.C. WhiteFoam Dressing change interval
Continuous for first 48 hours Intermittent (5 min ON / 2 min OFF) for rest of therapy 50 - 125 mmHg* 125 – 175 mmHg Titrate up for more drainage Every 48 - 72 hours but no less than 3 times a week. For infected wounds dressings may need to be changed more frequently

* The higher pressures within the stated target pressure range are preferred. In cases of intolerance, using lower pressure is an option but ensure that active exudate removal occurs

Special considerations V.A.C. Therapy in lower extremity ulcers

  • It is important to identify underlying ulcer aetiology and use relevant measures to address underlying disease processes
  • If the patient's skin cannot tolerate frequent dressing changes it may not be necessary to remove the entire drape

V.A.C. Therapy recommended guidelines for skin grafts

Aims and objectives

  • Provide splintage and stability for skin grafts
  • Minimize shearing forces
  • Evacuate subgraft collection
  • Assist flap perfusion and graft take
Recommended settings for lower extremity ulcers – skin grafts only
Initial and subsequent cycle Target pressure V.A.C. GranuFoam Target pressure V.A.C. WhiteFoam Dressing change interval
Continuous for duration of therapy 75 - 125 mmHg* 125 mmHg Titrate up for more drainage Remove dressing after 4-5 days** when using either foam (drainage should taper off before removal)

* In cases of intolerance, using lower pressure is an option but ensure that active exudate removal occurs
** For skin graft fixation only

The following procedure is recommended when applying V.A.C. GranuFoam Dressing post-graft:

  • Select a single layer of wide-meshed non-adherent interposed dressing (not required for V.A.C. WhiteFoam)
  • Cut the non-adherent dressing to the size of the grafted area plus a 1cm border, so it extends about 1cm outside the staple line, and place it over the graft
  • Cut the V.A.C. GranuFoam to the same size as the non-adherent dressing and place it gently on top of the non-adherent layer
  • Prepare and apply the drape according to Step 4 of Dressing application technique
  • Apply the (Sensa)T.R.A.C.™ Pad or tubing according to Step 5 of Dressing application technique
  • Set negative pressure to the desired level
  • V.A.C. WhiteFoam may also be used for fixation of skin grafts, but a non adherent interposed dressing is not required

V.A.C. Therapy Units and Dressings




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