How To Prevent Periwound Maceration With VAC Therapy

Jason R. Hanft, DPM, and Maribel Henao, DPM

The technique consists of rolling a piece of Eakin cohesive seal into a tube shape in order to line the wound edges. This also warms the seal to body temperature, making it easier to mold the seal. Once you have rolled the Eakin cohesive seal to the accurate size and shape, you can manually apply it to the wound edges until the entire wound is covered.

   To ensure proper adhesion to the skin edges, make sure the area is dry and ensure that no other other skin preparations or creams are used. One can apply the Eakin cohesive seal over the VAC therapy adhesive drape, which the practitioner would place above the intact skin to frame the wound, or directly over the skin. This decision is based on the anatomical configuration and depth of the wound.

   Additionally, the clinician can also apply the Eakin cohesive seal over any secondary dressing (such as Mepitel) used for a graft. At this time, it is better to place the VAC therapy adhesive drape over the Eakin cohesive seal instead of the skin due to the secondary dressing applied for the graft.

   Proceed to apply the VAC therapy adhesive drape and make the sponge cut to fit the size and shape of the wound. It is important to roll the VAC therapy adhesive drape into the Eakins cohesive seal in order to create an airtight area and prevent a loss of fluid.

   When you turn on the VAC therapy unit, negative pressure occurs and brings the Eakin cohesive seal securely against the tissue, maintaining a tight seal.

   Physicians can perform this technique in any anatomical area, which is prone to periwound maceration. This includes wounds with little space or those around other structures. This technique is also effective for highly exudating wounds and irregular shaped wounds. It is an easy and inexpensive technique that can be performed by any clinician applying VAC therapy.

   The consequences of an incomplete seal can delay wound healing and even bring damage to the periwound skin, creating an even larger wound. The aforementioned technique can prevent this from occurring and create an environment for more rapid wound closure.

Final Notes

Due to the seal’s many advantages and its effectiveness in stomas, its use with VAC therapy and difficult wounds make it a great choice to help diminish the complications of periwound maceration.

   Dr. Hanft is the Director of Podiatric Medical Education at Baptist Health in South Florida. He is a Fellow of the American College of Foot and Ankle Surgeons.

   Dr. Henao is a second-year resident at South Miami Hospital in South Miami.

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