Vac – Amputated great toe

Firstly setup your sterile field, opened all your sterile products onto the field, washed your hand and put on your sterile gloves.

Clean the wound bed first and then proceed to the peri-wound remember to demonstrate Aseptic Non Touch Technique.

With A different set up forceps paint the peri-wound with friars balsam and allow to dry. Feel free to fan the area to help increase the evaporation of the liquid.

** If patient’s peri-wound is oedematous you may need to do this step twice**

Visually cut the first piece of foam to size. You can put it onto the wound bed and adjust if necessary (I did not do this in the video). Once the piece is cut to size grab your first film piece. I cut mine into 6 equal pieces so that i can manage them easier.

I find it easy to partially open my first piece of film and stick the foam to it. This allows for easy placement. Then place the remainder of your film to make a air tight seal.

Cut a small (1-2cm long and 1-2cm wide) hole in the film you just placed on top of the foam. This will connect the wound bed to the bridge we are making.

The film you have laid down before to secure the first piece of foam will protect the patient’s skin. If there is no film on the patient’s skin where the foam needs to go you will need to add more.

Cut a piece of foam the length your bridge needs to be. The same technique of sticking the film to the foam was used to make life easier.

Cut a hole in your bridge so that your last piece of foam can sit on top of it. This technique is called (at least for me) the ‘Mushroom technique’ .

Cut a piece of foam the  slightly bigger than the size of the track pad and then secure with film.

Invert your scissors and cut a large hole the size of the track pad in the film covering the mushroom. If the hole is too small then the vac machine will think there is a blockage in the line.

** Think 50c piece **

Place the track pad on and then removed the blue pull tab attached to it.

Connect the dressing to the vac cannister (Activac cannister 300ml shown). Then place the cannister  into the machine and turn on.

** Apply the appropriate settings for your patient. Click the above link for the Vac machine and it will guide you to the appropriate settings**

Work your hands around 1-2cm around the outside of the vac foam as the machine sucks down. This will aid in stopping any leaks forming. If a leak is found then where you place your hand and the dressing sucks down is where the hole is. Sometimes they can no be seen only heard.

Double thumbs up! You did it. If there is any film left keep it as you can use it to plug any holes that may occur over the next 2 days.

Be like The Fonz