(NPWT) including Vacuum Assisted Closure (Vac) - Royal United ...

10. Patients with open abdomens
• The open abdomen is a technique also known as laparostomy, in which the
fascia is left open intentionally to avoid elevation of intra-abdominal pressure and
where surgical re-exploration is desirable. Temporary abdominal closure can be
achieved using a dressing or technology intended to protect the exposed viscera
(KCI, 2009; Garner, 2001).
• The abdominal dressing NPWT system can assist to stabilise the abdominal
wall, quantify and collect exudate, protect the intra-abdominal viscera and keeps
the fascia intact and the cutaneous plane for subsequent closure (Caro et al.
2011).
• Patients with open abdomens must be referred to the TVN via Millennium within
24 hours for consideration of specialized NPWT pumps & dressings designed
specifically for the open abdomen.
• Ward staff will not perform NPWT assessments or apply NPWT to the open
abdomen, this must be managed by the patients’ consultant with appropriate
involvement of the TVNs. Each patient will be managed individually (KCI, 2009).
• All patients with NPWT insitu over an open abdomen who are well enough to
mobilise should be assessed for corsetry and mobilized cautiously. This is to
ensure that the NPWT seal is maintained.
• For further information on the open abdomen and NPWT, please refer to the
‘Clinical guidelines for the management of the open abdomen with KCI systems
for active abdominal therapy’ (KCI, 2009) (See Tissue Viability intranet site).
11. Consent
• Verbal consent must be gained from the patient and this will be documented in
the patient’s medical notes.
• A patient information leaflet should be given and discussed with all appropriate
patients and carers and is available on the Tissue Viability intranet. Patients
MUST be monitored for any signs of bleeding and be educated on the
importance of seeking assistance promptly in the case of haemorrhage (FDA,
2009; 2011).
Document name: Negative Pressure Wound Therapy (NPWT) Ref.: 745
Issue date: 10 June 2013
Status: Approved
Author: Kate Purser and Nicola Heywood Page 10 of 20