Quick Overview
Categories
Scope of Practice (ScOP) Designation
Aim of Dressing
Safely remove the vac dressing from the 5 day old split skin graft (SSG) that was placed in surgery. The ssg may stick to the interface dressing which is why time and patience is required when taking down this dressing.
Tips & Tricks
1) Turn the Vac off 30min before removing the vac to allow to vac foam to separate from the SSG as much as possible 2) Slow and steady wins this race 3) Using the BACK of the forceps you can push down the skin graft if it rises a small amount when removing the vac foam
Dressing Changes (Min - Max)
5 days after split skin graft surgery
Shopping List
Dressing Pack (Large)
Jumbo Sterile Mouth Swabs
Metal Forceps (Block End Blunt)
Sterile Scissors
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
Tutorial Steps
Swipe
Turn the vac off 30min before attending to the dressing
Slowly lift and cut the foam making sure the scissors are not near the SSG
Slowly peel back the foam. This may mean using normal saline and the sue of sterile forceps (see step 4)
Using the BACK of the sterile forceps push any SSG that rises off the wound bed back down carefully. The technique is lift the foam slightly and then sneak the back of the forceps between the foam and the interface dressing and push the SSG down. DO NOT lift the foam a large amount and then reactively push the graft back down. This will only make the SSG bunch up.
Using sterile MOUTH SWABS saturate them with normal saline and then roll (NOT scrub) over the SSG. This has a double action of cleaning the SSG as well and pushing it down onto the wound bed.
General Notes
What have we learnt:
1.Always have the patient laying in bed as it will take a while
2.Turn Vac off over 30min before attempting to take the dressing down
3.Due to the graft being circumferential I had to cut the initial part of the vac foam VERY carefully. If this was just a single area you could peel the vac foam off whilst watching out for any staples that maybe anchoring it
4.Make sure your patient has some pain relief. This particular patient has chronic pain
5.Leave excess blood or excess dried skin graft attached and allow it to fall off in time