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NPWT Using Eakin

Author: Jo Hoeflok RN, BSN, MA, CETN(C), CGN(C) Advanced Practice Nurse, St. Michael’s Hospital, 416-864-5112
 
This case study examines the use of Eakin Cohesive® Seals combined with Negative Pressure Wound Therapy on a large perineal wound.
 
Clinical Issue:
  • Large perineal wound after surgical debridement
  • Required NPWT, but due to the difficult location, ensuring a tack with the thin film was problematic
  • Eakin Cohesive® provided the surface and seal for the NPWT, allowing for twice weekly changes of the NPWT system.

Supplies Needed:

  • Pre-medication for pain prior to dressing removal
  • Eakin Cohesive® Skin Barrier (839003) - cut into 1 inch strips
  • V.A.C.Via™ Spiral GranuFoam™ Dressing
  • Extra thin film (may not be needed)
  • Non-sterile gauze
  • Adaptic®
  • Scalpel/ scissors to prepare GranuFoam™
Spiral Granufoam™ Dressing:Spiral Granufoam™ Dressing:Spiral Granufoam Dressing:
  • Pulls out into long strip
  • Easier for application
  • Otherwise, take small sponge and cut into a spiral

 

 

 
 
Cavity:Cavity:Cavity:
  • Posterior vaginal wall exposed
  • Needs to be protected with Adaptic®
                                              
Dressing Application:
  • Start with patient on her abdomen
  • Additional hands help to keep buttocks pulled apart for application of sponge
  • Needs Eakin Cohesive® in superior gluteal fold
  • Bridging of sponge onto adjacent buttock for T.R.A.C.™ pad
  • Ensure thin film under bridged portion.

Application:

 

Step 3Step 3Step 2Step 2Step 1Step 1

 

 

 

 

 

 

Step 5Step 5Step 4Step 4 

 

 

 

 

 
 
 
 
 
 
 
 
Step 1: Apply Eakin Cohesive® to gluetal fold and apply bridge for T.R.A.C.™ pad. Tuck tip of spiral into deep wound bed and fill cavity
Step 2: Apply Eakin Cohesive® to peripheral skin to help with adhesion of thin film
Step 3: Cut hole in bridge for T.R.A.C.™ pad and attached T.R.A.C.™ pad but do not apply suction
Step 4: The patient was then repositioned to lie on her back and Eakin Cohesive® was applied in strips along inner groins. The remaining cavity was filled with foam, ensuring Adaptic® is lined up against posterior vaginal wall. Rolled up single 4 x 4 gauze is placed in between sponge and vulva and then covered with a piece of Eakin Cohesive®
Step 5: Cover area with thin film, ensuring that urethra is still exposed to allow for voiding. Establish suction at 75mHg continuous therapy