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Negative Pressure Wound Therapy Clinical GuidelineDecember 2016 (v4) Skin Care

Policy Number

LCH-81

This document has been reviewed in line with the Policy Alignment Process for Liverpool Community Health NHS Trust Services. It is a valid Mersey Care document, however due to organisational change this FRONT COVER has been added so the reader is aware of any changes to their role or to terminology which has now been superseded. When reading this document please take account of the changes highlighted in Part B and C of this form.Part A – Information about this DocumentPolicy Name Topical Negative Pressure (including Vacuum Assisted Closure)

Policy Type Board Approved (Trust-wide) ☐ Trust-wide ☐ Divisional / Team / Locality ☒

Action No Change ☐ Minor

Change ☐ MajorChange ☐ New

Policy ☒ No LongerNeeded ☐

Approval

As Mersey Care’s Executive Director / Lead for this document, I confirm that this document:a) complies with the latest statutory / regulatory requirements,b) complies with the latest national guidance,c) has been updated to reflect the requirements of clinicians and officers, andd) has been updated to reflect any local contractual requirements

Signature: Date:Part B – Changes in Terminology (used with ‘Minor Change’, ‘Major Changes’ & ‘New Policy’ only)

Terminology used in this Document New terminology when reading this Document

Part C – Additional Information Added (to be used with ‘Major Changes’ only)Section /

Paragraph NoOutline of the information that has been added to this document – especially where it may

change what staff need to do

Part D – Rationale (to be used with ‘New Policy’ & ‘Policy No Longer Required’ only)Please explain why this new document needs to be adopted or why this document is no longer required

Part E – Oversight Arrangements (to be used with ‘New Policy’ only)Accountable Director

Recommending Committee

Approving Committee

Next Review DateLCH Policy Alignment Process – Form 1


SUPPORTING STATEMENTS This document should be read in conjunction with the following statements:

SAFEGUARDING IS EVERYBODY’S BUSINESS

All Mersey Care NHS Foundation Trust employees have a statutory duty to safeguard and promote the welfare of children and adults, including: being alert to the possibility of child / adult abuse and neglect through their observation of

abuse, or by professional judgement made as a result of information gathered about the child / adult;

knowing how to deal with a disclosure or allegation of child / adult abuse; undertaking training as appropriate for their role and keeping themselves updated; being aware of and following the local policies and procedures they need to follow if they

have a child / adult concern; ensuring appropriate advice and support is accessed either from managers, Safeguarding

Ambassadors or the trust’s safeguarding team; participating in multi-agency working to safeguard the child or adult (if appropriate to your

role); ensuring contemporaneous records are kept at all times and record keeping is in strict

adherence to Mersey Care NHS Foundation Trust policy and procedures and professional guidelines. Roles, responsibilities and accountabilities, will differ depending on the post you hold within the organisation;

ensuring that all staff and their managers discuss and record any safeguarding issues that arise at each supervision session

EQUALITY AND HUMAN RIGHTS

Mersey Care NHS Foundation Trust recognises that some sections of society experience prejudice and discrimination. The Equality Act 2010 specifically recognises the protected characteristics of age, disability, gender, race, religion or belief, sexual orientation and transgender. The Equality Act also requires regard to socio-economic factors including pregnancy /maternity and marriage/civil partnership.

The trust is committed to equality of opportunity and anti-discriminatory practice both in the provision of services and in our role as a major employer. The trust believes that all people have the right to be treated with dignity and respect and is committed to the elimination of unfair and unlawful discriminatory practices.

Mersey Care NHS Foundation Trust also is aware of its legal duties under the Human Rights Act 1998. Section 6 of the Human Rights Act requires all public authorities to uphold and promote Human Rights in everything they do. It is unlawful for a public authority to perform any act which contravenes the Human Rights Act.

Mersey Care NHS Foundation Trust is committed to carrying out its functions and service delivery in line the with a Human Rights based approach and the FREDA principles of Fairness, Respect, Equality Dignity, and Autonomy


Title Negative Wound Pressure Therapy (NWPT) Clinical Guideline

Guideline reference number

81

Aim and purpose of clinical document

To provide evidence-based guidance in assisting Liverpool Community Health NHS Trust employees in the identification of indications for use and the management of Negative Pressure Wound Therapy to benefit patient care

Author Skin Care Service – Jenny Francis

TypeNew document

Reviewed document

Review Date December 2018

Person/group accountable for review

Clinical Standards Group

Type of Evidence base used B: Evidence from multiple unacceptable studies or a

single acceptable study (weak or inconsistent evidence) C: Evidence which includes published and/or unpublished studies and expert opinion (limited scientific evidence)

Issue date

Authorised by Clinical Standards Group

December 2016

Impact Assessment Undertaken

Yes date when undertaken

30/04/10No

Evidencecollated


Document Control for Revised GuidelineVersion FourRatified by:Date of Approval:

Clinical Policies Working Sub-Group

Name of originator / author Skin Care Service – Jenny FrancisApproving body / committee: Clinical Policies Working Sub-Group

Date issued: December 2016

Review date: December 2018Target audience: All clinicians involved in the use of

negative wound pressure therapy in wound Name of lead Director / Managing Director

Sue Page Interim Chief Executive


Changes / Alterations made to previous version

Inclusion of manufacturer information relating to other Negative Pressure Wound Therapy systems commonly used within LCH

Format changes to guideline - Changes in line with policy: An Organization -wide Policy for the Development and management of Clinical Guidance Documents (2009)

References – Updated to reflect developments in clinical evidence

Appendix 1 – KCI Medical (an Acelity Company) product information embedded.V.A.C Therapy: Clinical Guidelines: A reference source for clinicians.

Appendix 2 : KCI Acti V.A.C Negative Pressure Therapy System alarms Troubleshooting.

Appendix 3 : KCI Acti V.A.C Therapy Competency Form.

Appendix 4 : - Mölnlycke product information embedded.Avance Clinician’s Guidelines, user guide and Troubleshooting.

Appendix 5: - Molnlycke Avance Clinical Competency training form.

Appendix 6: - Smith and Nephew PICO Community usage guide, Patient Information Leaflet and ordering information

Appendix 7: - NPWT Supplementary Skin Care Service Referral Form

Appendix 8: – NPWT Therapy Checklist

Appendix 9 : – NPWT Record of Management

Appendix 10: – NPWT Patient Information

Leaflet.

Appendix 11: - NPWT Audit Tool


Contents

Section Page Number

1. Purpose 52. Scope 53. Negative Pressure Wound Therapy 54. Definitions 55. Indications of Use 66. Contraindications / Precautions to NWPT 77. Training 88. Equality Analysis 89. Audit 810.Associated Documentation 811.References 8

Appendices

Appendix 1 : KCI Medical V.A.C Therapy Clinical Guidelines; A reference form for Clinicians.Appendix 2: KCI Acti V.A.C Negative Pressure Therapy System Alarm Troubleshooting.Appendix 3: KCI Acti V.A.C Therapy Competency FormAppendix 4 : Molnlycke NWPT Avance Clinician’s Guidelines, user guide and troubleshooting.Appendix 5: Molnlycke Avance Clinical Competency form.Appendix 6: Smith and Nephew PICO Community usage guide, Patient Information Leaflet and ordering informationAppendix 7 : Supplementary Referral FormAppendix 8 : Negative Pressure Wound Therapy ChecklistAppendix 9 : Negative Pressure Wound Therapy – Record of ManagementAppendix 10 : Patient Information LeafletAppendix 11: Audit Tool


1. Purpose of the Guideline

This clinical guideline is intended to provide evidence-based guidance to identify the indications for use and management of Negative Pressure Wound Therapy within Liverpool Community Health NHS Trust (LCH). Whilst providing support for Registered Health Professionals.

2. Scope of the Guideline

This guideline applies to any registered health professional employed by LCH who is involved in the management of patients with wounds requiring Negative Pressure Wound Therapy.

3. Negative Pressure Wound Therapy

Negative Pressure Wound Therapy (NPWT) also known as Topical Negative Pressure (TNP) or Vacuum Assisted Closure (VAC), is a non-invasive closed wound management system that applies either continuous or intermittent sub-atmospheric pressure to promote improved wound healing in chronic, difficult to heal wounds. It provides a closed system that will protect the wound from external sources of contamination, whilst creating optimal conditions for complex wounds (Huddleston, 2015).

There are several methods of providing negative pressure to the wound bed now available, including using foam and gauze based systems, which allow clinicians to select the most suitable for the wound in question. Until recently VAC (manufacturer KCI medical, an Acelity company) was the main system available. However the use of other NPWT systems may be considered on an individual patient basis, if it is deemed to provide a clinical advantage.

NPWT is both a clinically and cost effective treatment that can be used to provide maximum therapeutic benefits to the patient with complex needs. (Wounds UK, 2008).

3.1 Negative Pressure Wound Therapy in LCH

LCH currently use a variety of different NPWT systems. The specifics of which for each will be covered within this document. Patients may be discharged from the acute setting with NPWT already in place or alternatively NPWT can be commenced in Primary Care. The Skin Care Service currently manages all patients on NPWT under a shared care arrangement with District Nurses who fall under the remit of Liverpool CCG. LCH patients who fall under Sefton CCG on NPWT are currently managed solely by District Nurses. Clinicians who feel they have a patient who would benefit from NPWT should contact the Skin Care Service on 0151 295 9415 who will advise accordingly. Skin Care Service referral form can be downloaded via the following link

Skin Care Service | LCH Intranet


4. Definitions

Taken from the Oxford Concise Medical Dictionary (Oxford University Press 2003)

Term DefinitionAngiogenesis the formation of new blood vesselsDebriding/Debridement Removal of devitalised (dead) tissue

and foreign matter from a wound by various means

Fistula An abnormal communication between two hollow organs or between a hollow organ and the exterior.

Haemostasis the arrest of bleedingKCI Medical Kinetic Concepts, Inc. – Manufacturer

of VAC NPWT systemMicrovascular involving small vesselsMölnlycke Manufacturer of Avance NPWT systemOsteomyelitis inflammation of the bone due to infectionPICO◊ Single use NPWT SystemTherapeutic Pause A period of time of 1 – 2 days whereby

therapy is interrupted to promote an improved response when there has been minimal changes in the wound.

Mode of action

Removal of interstitial fluid: The removal excess interstitial fluid is thought to accelerate healing based on the observation that constituents of chronic wound fluid are known to be detrimental to wound healing. Secondly localised oedema in both acute and chronic wounds can compress surrounding microvascular and lymphatic channels, the action of negative pressure is thought to decompress small blood vessels thereby restoring their flow.

Delivery of mechanical stress to the wound: whereby a centripetal force is created which uniformly draws the wound edges together.

Provides moist wound environment; thought to contribute to wound healing. By decompressing the small blood vessels it is thought that

angiogenesis and local blood flow is stimulated. Reduction in bacterial count: Increased blood flow serves to increase

tissue oxygen concentrations thereby inhibiting the growth of anaerobic organisms. The bacterial load may be reduced as excess exudate or loose slough is removed from the wound.

Promotes granulation: The response is thought to be due to a combination of mechanical force, moist environment and removal of inhibitory factors.

(Armstrong et al 2005)


5. Indications for Use

The indications for use of NPWT can vary depending on manufacturer guidelines. For example, PICO◊ system is indicated for more superficial wounds with low to moderate exudate level. For this reason it is recommended that clinicians considering use of NPWT consult the relevant manufacturer guidance for the product to ensure its suitability.Generally, NPWT is indicated for patients with chronic, acute, traumatic, sub acute and dehisced wounds, partial-thickness burns, pressure and diabetic ulcers, flaps and grafts (KCI Medical 2007), also as part of incisional management, reducing the risk of post-operative infection, haematoma and dehiscence (Karlakki et al 2013).

The treatment objective should be considered (Vowden et al 2007) and including: Manage excessive exudate as it affecting care, skin integrity or quality of life Promote rapid improvement in wound bed, before surgical wound closure in

skin graft Improve vascularity of wound bed and /or promote granulation tissue Stabilise wound graft or flap and aid care and rehabilitation Promote healing when healing is not progressing with conventional dressings To reduce potential post-operative swelling oozing

All other factors that may impact on wound healing should be addressed prior to commencing NPWT therapy and adequately managed. eg nutritional compromise. NPWT should be regarded in the same way as other wound care interventions: It should be selected if it provides the most clinically and cost- effective method for achieving defined therapeutic goals.

Once NPWT therapy has been selected therapeutic goals should be defined and progress carefully and frequently monitored. NPWT therapy must be introduced with a defined goal and exit strategy and should be stopped once the goals have been achieved, if treatment is not meeting defined aims in an acceptable timeframe, or it is unacceptable to the patient or causes complications (Vowden et al 2007).

The length of treatment depends on the treating physicians goal of therapy; wound pathology ie. wound dimensions and management of the patients co- morbidities. The average length of treatment is 4-6 weeks; however therapy can be used for longer periods if satisfactory progress continues (KCI Medical 2007)


7. Contra Indications / Precautions to

NPWT Therapy Contraindications

Malignancy in wound (known or suspected): When mechanical stretch is applied to normal cells, it results in increased proliferation. However, biologically, cancerous cells are often not anchored and do not respond to the same stimuli as healthy cells, thereby rendering negative pressure ineffective.

Fistula of unknown origin: To avoid sealing unexplored cavity. The base of the wound must be established to avoid damage to any unknown organs or vessels.

Exposed arteries or veins: Potential to cause damage to vessels. Necrotic tissue with eschar: Negative pressure effects cannot be

achieved at wound bed if covered with slough or necrotic tissue. Wound would require debriding prior to assessment for NPWT therapy

Untreated Osteomyelitis: Necrotic bone requires removing prior to NPWT therapy to reduce incidence of future occurrence. Osteomyelitis must be treated 2 weeks prior to NPWT therapy commencement.

Active bleeding: Cause of bleeding must be established and treated prior to TNP therapy

PrecautionsTo avoid active bleeding caution should be taken for patients with:

Difficult wound haemostasis Patients on anticoagulation therapy NPWT dressing in close proximity to blood vessels or organs. Weakened, irradiated or sutured blood vessels or organs In the presence of bone fragments or sharp edges. Patients who do not have adequate tissue coverage over vascular structures

(Gupta et al 2004, KCI Medical 2007)

8. Training

Training in the use of NPWT will be delivered in practice to clinicians who are managing this group of patients. Training will be delivered by the Skin Care Service in conjunction with other competent clinicians and the system manufacturer.

9. Equality Analysis

This has been undertaken and the evidence has been retained by the authors and the Equality and Diversity Lead of LCH


11. Audit

Responsibility of audit of this guideline will fall to individual services who use the therapy as identified in their yearly audit plan or in response to an associated clinical incident if deemed appropriate.

12. Associated Documentation

Disposal of clinical waste should be completed in line with Waste Management Policy (LCH 2014)

http://nww.liverpoolch.nhs.uk/Downloads/SERVICES/CORPORATE/Governance/R isk- Management/Health-Safety-Policies/Waste-Management-Policy.pdf

This guideline should be used in conjunction with the Wound Assessment Guideline, Wound Debridement Guideline, Infected Wound Guideline and other relevant clinical guidelines available at:

Clinical Policies | LCH Intranet


11. References

Armstrong, D,G. Boulton, A,J,M. Banwell, P,E. (2005) Topical Negative Pressure: Management of Complex diabetic Foot Wounds. The Oxford Wound Healing Society.

Banwell.P.E, Teot. L. (2003) Topical negative pressure (TPN): the evolution of a novel wound therapy. Journal of Wound Care. Vol 12, 1.

Gupta S (ed) (2004) Guidelines for Managing Pressure Ulcers with Negative Pressure Wound Therapy. Advances in Skin and Wound Care. Suppl 2. 1-16. ISSN.1527-7941.

Huddleston, E. (2015). What is the mode of action of negative pressure wound therapy? Cited in Reducing the burden of chronic wounds in the community with single-use NPWT. Journal of Community Nursing Supplement: 2015, vol 29, no 5.

Karlakki S, et al (2013) Negative Pressure Wound Therapy for management of the surgical incision in orthopaedic surgery. Bone Joint Res 2013;2:276-84.

KCI Medical (2007) V.A.C Therapy Clinical Guidelines. A reference source for clinicians.

Purchasing and Supply Agency (2008) Evidence Review. Vacuum Assisted Closure

Steed,D,L. Attinger, C. Colaizzi,T. et al (2006) Guidelines for the treatment of diabetic ulcers. Wound Repair and Regeneration 14 680–692. The Wound Healing Society

Teot,L, Lambert,L, Ourabah,Z et al (2006) Use of topical negative pressure with a lipocolloid dressing: results of a clinical evaluation. Journal of Wound Care. Vol 15:8

Vowden et al (2007). Topical Negative pressure in wound management. www.woundsinternational.com/media/issues/84/files/content_46.pdf

Wounds UK (2008) Best Practice Statement: Gauze based Negative Pressure Wound therapy. Aberdeen, Wounds UK.www.wounds-uk.com/pdf/content_8948.pdf [accessed 31/10/16].

APPENDIX 1:

KCI Medical (an Acelity Company) NPWT V.A.C Therapy: Clinical Guidelines: A reference source for clinicians.

Appendix 2:

KCI ACTI V.A.C Troubleshooting quick reference guide

APPENDIX 3:

KCI V.A.C Therapy Competency Acti V.A.C Therapy unit.

Appendix 4:

Mölnlycke NWPT Avance Clinician’s guidelines, User Guide and Troubleshooting.

APPENDIX 5 :

Molnlycke Avance Clinical Competency Training Form.

Appendix 6 :

Smith and Nephew PICO NWPT: PICO Community usage guide, Patient Information Leaflet and ordering information


APPENDIX 7 :

Supplementary Referral Form Skin Care Service

Lifehouse Summers Road

Brunswick Business ParkLiverpool

L3 4BLTel: 0151 295 9415Fax: 0151 296 7528

Supplementary Referral Form for Patients Requiring NPWT on Discharge from Hospital to Liverpool Community Health

This supplementary referral form is for NPWT therapy only and does not replace the normal discharge documentation for the Skin Care Service or District Nurses

CriteriaPatient’s wound meets criteria for use of NPWT therapy and has no contraindications, any precautions identified on discharge documentation.Patients need to be registered with a Liverpool based GP or reside within the Liverpool area.A risk assessment must be performed prior to discharge as to the suitability of NPWT therapy for the individual patient in their home environment.

Prior to DischargeNPWT consumables form part of the patient’s take home supplies from pharmacy i.e. one week supply of the foam/gauze dressings and canisters should be sent home with the patient. This includes any additional dressings used in the procedure such as low- adherent or thin hydrocolloid dressing. PICO◊ should also be provided on discharge.

The Skin Care ServiceThe Skin Care Service must have this form faxed 48hours prior to commencing NPWT therapy within LCH to agree funding arrangements and where possible will provide a joint visit with District Nurses on the day of first dressing change. They will also provide ongoing support in the management of NPWT therapy.

District NursesEnsure that District Nurses are informed of date of patient discharge; they will visit on that date to complete a checklist to provide initial patient support, maintain continuity of care and ensure the patient’s safety at home with their NPWT. They will require this form to be faxed to confirm pressure settings etc. Ensure the patient has District Nurse contact telephone number on discharge. Other holistic patient assessment referral needs should be identified via the normal district nurse discharge planning route and documentation.


Supplementary Referral Form for Patients Requiring TNP Therapy on Discharge from Hospital to Liverpool Community Health

Patient NameNHS numberDate of Birth

Date patient commenced NPWT therapy (in hospital)Wound type (e.g. pressure ulcer) and wound siteRationale for requiring NPWT therapy in LCHWound dimensions (cm) Length Width Depth

Undermining/Sinus(delete)Type of therapy unit required ActiVAC Avance PICO◊ Wound Filler Foam: Black White Green Size:

Gauze: Number Used:Therapy pressure Unit setting: mmHg Intermittent Continuous Dressing change (circle) Mon Tue Wed Thur Fri Sat SunDate of patients next out patient appointmentPAYMENT DETAILS Transfer of payment Unit to be sent in Any associated caution factors for the use of NPWT therapy should be identified anddiscussed with the Skin Care Service prior to discharge. e.g. osteomyelitis treated,malignancy excluded.

…………………………………………………………………………………….

………………………………………………………………………………………………………………

……………………………………………………………………………………………………………….

……………………………………………………………………………………………………………….

Date of first DN visit: Date of next dressing change:

Hospital: Ward:

Person referring: Contact number:

Signature: Date and time:


APPENDIX 8 :NEGATIVE PRESSURE WOUND THERAPY CHECKLIST (ActiVAC and Avance)This form provides a checklist of factors to facilitate care for patients receiving NPWT in LCH, It should be used on the day/evening of patient’s initial discharge from hospital and DOES NOT replace:

District Nursing Assessment documentation NPWT Documentation – (Care Plan and Record of Therapy Management).

The NPWT Unit YES NOIs the unit storage case intact?Is the carrying holder and zip intact?Are the detachable power cord and plug intact?When the unit is plugged in to an AC power supply does the indicator appear on the monitor to indicate that the unit is charging?Does the canister fit securely into the unit?Does the unit operate when therapy settings have been set and therapy commenced? (If NO, Check mains connection or that battery is Does the NPWT unit settings correspond to the recommended on hospital discharge information?

Unit Serial Number…….………....... Details of therapy settings: .........................................If the answers to any of the above questions are NO please inform the Skin Care Service. Any faults with medical devices should be reported via guidance within Guidelines for the Management of and Training needs for Medical Devices and Equipment (LCH 2012)

Patient Information (Please tick)Patient/Carer informed of how to charge NPWT unit via mains electricity supply The information below has been discussed with Patient and / or carerPatient/Carer aware to check the therapy unit is switched on the foam/gauze is wrinkled and shrunk down on a regular basis and able to respond should the NWPT unit alarm The monitor will indicate the nature of the problem. The alarm will sound:

o When the canister is fullo When there is a leak/break in sealo When the battery is lowo When the power is on but the therapy unit is not workingo The tubing is kinked or blocked

The settings on the monitor should not be altered without discussion with a nurseIf the problem cannot be solved, District Nurses should be contacted day or night anda new NPWT or alternative dressing may be applied.The unit must not be switched off whilst remaining on the wound for more than 2 hours as this may result in a delay in healing.Customer Service Helpline (24hr)KCI Medical (an Acelity Company) 0800 980 8880Mölnlycke 0870 60 60 766

Name and Signature..................................................Date and Time..........................……..….


APPENDIX 9 :

NEGATIVE PRESSURE WOUND THERAPY – RECORD OF MANAGEMENT

THERAPY UNIT MODEL (circle) ActiVAC/Avance/PICO◊ UNIT SERIAL NUMBER (if applicable)…………………….

Please complete the following on every NPWT dressing change

Wound re/assessment should be completed on Trust documentation. **If there are indications of infection please refer to NPWT individual manufacturer and or LCH guidelines. *Any problem identified e.g. unit alarming should be recorded in nursing documentation with appropriate action taken.

Date

And Time

Wound filler type and amount used (Black/Green/ White Foam/Gauze)

Therapy pressure setting

Therapy cycle Intermittent

or Continuous

Wound margins bordered? If Yes type

Liner

used? Y/N.

If Yes type

Exudate: colour and approx amount

Canister changed

Y/N or n/a

Therapy unit charged and working correctly?Y / N*

Indications of Infection

Y** / N

Name and Signature

Example

1/01/07

10AM

2 Black 125mmHg Intermittent Duoderm Mepitel 100ml Haemoserous

Yes Yes No N. E. Body

CARE PLAN No:


Date

And Time

Wound filler type and amount used (Black/Green/ White Foam/Gauze)

Therapy pressure setting

Therapy cycle Intermittent

or Continuous

Wound margins bordered? If Yes type

Liner

used? Y/N.

If Yes type

Exudate: colour and approx amount

Canister changed

Y/N or n/a

Therapy unit charged and working correctly?Y / N*

Indications of Infection

Y** / N

Name and Signature

December 2014 (v3) Skin Care Service

APPENDIX 10: - Patient Information Leaflet

N

egative Pressure Wound Therapy Clinical Guideline

December 2014 (v3) Skin Care Service

Negative Pressure Wound Therapy Clinical Guideline


APPENDIX 11: - Audit Tool

Speciality e.g. Team / Ward………………………………………………………...

Date of episode of care: ............…...................................................................

Date of Audit: …………………………………………………………………………

Completed by: (name /designation) ………………………………………………

Audit Identifier: ……………………………………………………………………….

This audit tool should be used in conjunction with other relevant audit tools

CRITERION EXCEPTION ACHIEVEDYES NO N/A

1) PATIENT/HOLISTIC ASSESSMENT1.1 Is there evidence that the risks/benefits/ Nonealternatives of NPWT were discussed with patient prior to treatment?1.2 Is there evidence that consent to NPWT Nonewas obtained?1.3 Is there evidence that a rationale for the Noneuse of NPWT was identified?1.4 Is there evidence that consideration was Nonegiven to contraindications/precautions to NPWT therapy?2) NPWT WOUND MANAGEMENT2.1 Was the type of NPWT wound filer used No filleridentified? required ie.

PICO◊2.2 If foam was lined, was a suitable low adherent lining identified?

No liner required

2.3 Is there evidence that the number of Nonefillers used was recorded on each dressing change?

2.4 Is there evidence that frequency of NPWT therapy dressing changes was recorded?

None

Negative Pressure Wound Therapy Audit Tool


2.5 Is there evidence that the NPWT canister was changed at least every 7 days?

None

2.6 Is there evidence that the colour and amount of exudate in canister was

No canister ie PICO◊

2.7 Is there evidence that the peri-wound area was protected with the use of appropriate dressings e.g. hydrocolloid/film

No protection required ie Gauze filler or PICO◊

2.8 Was the pressure cycle recorded each time the wound was redressed?

PICO◊ (pre- set)

2.9 Was the NPWT pressure setting recorded each time the wound was redressed?

PICO◊ (pre- set)

2.10 Was there evidence that a patient information leaflet was provided?

None

2.11 Is there evidence that the patient/carer has been informed of actions/contact persons and telephone numbers should a problem with NPWT

None

2.12 Was a rationale for discontinuation of NPWT provided?

Where NPWT therapy is still in use