Wound Care Plan

VAC – Thigh wound with ‘Shoelace’ technique

Last Updated
12 June 2025
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Quick Overview

Reference ID Number: TWS-WCP-58

Categories

Negative Pressure Wound Therapy

Scope of Practice (ScOP) Designation

Medical Officer,Registered Nurse (RN),Enrolled Nurse (EN)

Treatment Goals

To reduce the tension on the wound by aiding in bringing in the wound edges and maximise secondary intention healing before a split skin graft is used to close the wound

Aim of Dressing

By utilising the surface vac technique we are able to 'sinch' the wound edges in whilst supporting exudate management.

Frequency of Dressing Change

3 Days(s) Min - 2 Days (Max)

References

Shopping List

Dressing Pack (Large),Normal Saline,Sterile Gloves (Size 7.5),Friars Balsam (25ml),Comfeel Plus (5cm x 25cm),Atrauman Silicone Dressing (10cm x 20cm),Vac Dressing Foam – Black – Medium,V.A.C.® Ulta,Vac Ulta Canister

Associated Tutorials

Vac – Forefoot with Bridge Dressing,Vac – Large leg wound with tunneling,Vac – Removing off a circumferential split skin graft,Vac – Exudate management of an infected femoral graft
Page Table of Contents

    Product Selection Disclaimer:

    The wound care products being currently used are a suggestion ONLY. They do not take into account your patient's individual needs which you must assess. No funding from medical companies has been provided and wound care products are chosen on their merit and what is available on the NSW Health State Wound Care Contract. Where an exact brand name product is not available we suggest you review the alternative tab or use another wound care product from its category eg. Hydrofibre

    Photo Gallery

    Care Plans

    Left thigh wound

    Patient had a traumatic injury causing a large deficit requiring both orthopedic and plastic involvement.

     Swipe 
    Step 1

    Clarify instructions

    Speak to the Medical Team who is in charge of the vac therapy. In this case it was the Plastic Surgeon. Be very specific around their needs. In this case it was what they wanted to do with the jelonet that was under the shoelaces. In this case we left it in till next dressing change and then we removed it.
    Products Used
    Step 2

    Prepare you sterile field

    Open products using ANTT onto your sterile field
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    Step 3

    Clean the wound bed

    Make sure you clean around the peri-wound very well as residue from the previous vac can build up
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    Step 4

    Preparing periwound #1

    Make sure the peri-wound is completely dry and then apply a generous amount of friars balsam
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    Step 5

    Preparing periwound #2

    Cut the comfeel in half length ways to make it easier to apply around the curvature of the wound. You dont have to run it up to the wound edge but but next to the staples keeping the shoelaces adhered to the skin. We will apply the silicone dressing to protect the skin.
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    Step 6

    Cut silicone dressing

    Cut the silicone dressing to overlap the comfeel dressing by 1cm and the wound bed.
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    Step 6

    Apply vac foam

    Apply the vac foam to the wound bed. The wound was very narrow so you will need to use the mushroom technique to make sure that the sensor pad doesn't think it is blocked.
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    Step 7

    Vac

    I avoid using an Activac as there was a fair amount of exudate for this patient.
    Products Used