promo-229-Guidelines for the use of topical negative

MERCY HEALTH
GUIDELINES FOR THE USE OF NEGATIVE PRESSURE THERAPY - RENASYS™ & PICO™
A comprehensive, holistic assessment of the patient
should be undertaken prior to commencing negative
pressure therapy including; general health, nutritional
status, psychosocial wellbeing and wound related pain1
Ensure wound bed preparation
has been attended to in order to
provide an optimal healing
environment2

AIMS OF NEGATIVE PRESSURE THERAPY3:




Set treatment aims for each
reduce oedema from the periwound and remove exudate
individual patient &
from the wound bed
evaluate
at each dressing
optimize healing environment and reduce wound size
increase microvascular blood supply & promote healthy granulation tissue
INDICATIONS FOR USE4:
CONTRAINDICATIONS FOR USE6:
•
•
•
Renasys™ or Pico™ negative pressure therapy is indicated for;
o dehisced surgical wounds where the wound has
exudate that cannot be contained within
traditional dressings
o chronic & traumatic wounds
Ensure all wounds that are to have negative pressure therapy
applied have been appropriately debrided to remove necrotic or
sloughy tissue prior to the application of Renasys™ or Pico™
Renasys™ or Pico™ may be considered to be applied
prophylactically in patients who are considered high risk of
surgical wound breakdown. This includes5:
• patients with a BMI of > 35
• patients with a history of wound breakdown or delayed
healing
• patients on corticosteroids
• patients with diabetes
• patients with multiple comorbidities
• history of a previous caesarean section
The decision to use Renasys™ or Pico™ prophylactically will be
based upon a comprehensive assessment of the patient.
RENASYS™
7
INDICATIONS FOR USE :
Wound depth > 2cm
Wound exudate: High level of exudate
Use foam or gauze filler
Consider using ACTICOAT™ Flex under Renasys™ if
infection present or suspected
Reassess at each dressing change
Dressing to be changed 2-3 times/week
•
•
•
•
•
Wounds with necrotic tissue or eschar
Caution if used over exposed organs,
blood vessels or tendon – must be
under medical supervision
Do not use in malignant wounds
(except where palliative care is
appropriate to enhance quality of life)
Do not use in wounds where there is
untreated or suspected osteomyelitis
Do not apply if a patient has severe
peripheral arterial disease
Do not apply to wounds where there
is a fistulae, sinuses or undermining of
undefined aetiology
Do not apply where there is
uncontrolled bleeding of the wound
bed or where a patient is taking
anticoagulants where the risk of
bleeding is heightened
PICO™
INDICATIONS FOR USE8:
Wound depth up to 2cm
Wound exudate – nil/low to moderate
Use no filler if wound < 0.5cm
Use foam or gauze filler if wound 0.5 – 2cm
If infection present or suspected, apply Acticoat™ Flex
on wound base
Designed to stay in place for up to seven days
NEGATIVE PRESSURE THERAPY SHOULD BE STOPPED WHEN ONE OR MORE OF THE FOLLOWING9:
 When the original goals of therapy have been met
 When there is 100% granulation tissue & the tissue is level with the surrounding skin
 When there is no notable improvement after two consecutive dressing changes
REFERENCES:
1-4. European Wound Management Association (EWMA). (2007). Position Document: Topical negative pressure in wound management. London: MEP Ltd.
5. Karlakki, S., Brem, M., GIannini, S., Khanduja, V., Stannard, J. Martin, R. (2013). Negative pressure wound therapy for management of the surgical incision
in orthopaedic surgery. BJR, 2(12), 273-284.
6-9. Smith & Nephew (ND). Renasys – Negative Pressure Wound Therapy Clinical Guidelines.