Simple Method to Prevent Sponge Retention in Cavity Wounds
A thorough assessment of the wound is performed to ensure adequate debridement and to allow mapping of the topographical layout of the tissue defect. The next step is to carve or cut polyurethane black foam (V.A.C. GranuFoam, KCI, San Antonio, TX), white foam (V.A.C. Vers-Foam, KCI, San Antonio, TX), or a combination of both so that when stitched or stapled together (Figure 1) the material will fill the defect with some left to protrude for the chosen tubing, in the authors' case SensaT.R.A.C. tubing (KCI, San Antonio, TX).
(Enlarge Image)
Figure 1.
Polyurethane foam, cut to fill a specific wound with a section that will protrude for recovery.
This sponge-model of the wound is then covered in a mesh wound contact layer (Mepitel, Mölnlycke Health Care US, Norcross, GA) and stapled or stitched together (Figure 2). This construct is extremely tear resistant which prevents the sponge from separating and being lost. The contact layer also reduces tissue ingrowth and adhesion, thereby minimizing trauma and pain during its extraction. After this combination of sponge and mesh wound contact layer is placed in the wound, the dressing draping and continuous vacuum therapy may be commenced. As per the manufacturer's guidelines for vacuum-assisted closure therapy, the authors recommend detailing the number and type of sponges used for the dressing in the patient's medical chart. The authors also trace the sponge model onto the plastic coating for the mesh contact layer to use as a template for the next sponge dressing change.
(Enlarge Image)
Figure 2.
The cut foam, covered with a mesh wound contact layer.
Material and Methods
A thorough assessment of the wound is performed to ensure adequate debridement and to allow mapping of the topographical layout of the tissue defect. The next step is to carve or cut polyurethane black foam (V.A.C. GranuFoam, KCI, San Antonio, TX), white foam (V.A.C. Vers-Foam, KCI, San Antonio, TX), or a combination of both so that when stitched or stapled together (Figure 1) the material will fill the defect with some left to protrude for the chosen tubing, in the authors' case SensaT.R.A.C. tubing (KCI, San Antonio, TX).
(Enlarge Image)
Figure 1.
Polyurethane foam, cut to fill a specific wound with a section that will protrude for recovery.
This sponge-model of the wound is then covered in a mesh wound contact layer (Mepitel, Mölnlycke Health Care US, Norcross, GA) and stapled or stitched together (Figure 2). This construct is extremely tear resistant which prevents the sponge from separating and being lost. The contact layer also reduces tissue ingrowth and adhesion, thereby minimizing trauma and pain during its extraction. After this combination of sponge and mesh wound contact layer is placed in the wound, the dressing draping and continuous vacuum therapy may be commenced. As per the manufacturer's guidelines for vacuum-assisted closure therapy, the authors recommend detailing the number and type of sponges used for the dressing in the patient's medical chart. The authors also trace the sponge model onto the plastic coating for the mesh contact layer to use as a template for the next sponge dressing change.
(Enlarge Image)
Figure 2.
The cut foam, covered with a mesh wound contact layer.
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