My 1st intervention ~Vacumm assisted dressing

This morning, i finally has a chance to do my very own vaccumm assisted dressing.. As i had learned it weeks earlier, so i might had some ideas how to deal with it.

For this procedure, i am asked to use some cheap stuffs to build a vaccumm assisted dressing with wall suction. And previously, i saw other patients using high tech stuff with an equipment cost about at least few thousands ringgit not including the accesoories...
So now, i am going to use a more economical stuff as we have inadequate machines in the ward.

So, the tressure hunts begin. Equipments needed are basically sponge, gauze, ryles tube, suture, suction tube and a big bottle . Initially i found an RM1 sponge that has been autoclav ~ super sterile.. i grab 2 sponge and put into my trolley. Then its time to find the suction tube.. Searching up and down for the tubes... tiring but interesting. Gauze , suture and ryles tube are easier to find as it is a common stuff used in ward. And lastly, i asked for a big bottle from the staff nurse. After everything done..its time to get myself sterile.

Before starting to do anything, i need to make sure the wall suction is powerful enough to suck the pus and keep the wound in a vacumm state. Luckily i found one but it was being used for a comma patient as he needs regular suction for his tracheostomy. Then, with a bad intention, i stole his suction and exchange a less powerful suction for him (still can be used~ i am still not that bad i think- p/s : i tested it already before i change. it is functional).

After attaching the pot filling with chlorhexidine and suction in situ, i cleaned and drapped the patient under sterile technique. Actually, he has a big cavity wound with big pouches filled with foul smelling psu which is an indication for us to do vacumm assisted dressing. So, i irrigated his wound with povidone iodine mixed with normal saline. Then, after drapping him up,i start to cut small holes along the ryles tube to create more holes so that more suctioning can be done. After that, the ryles tube is wrap with gauze and sutured with dafilon 3/0. And then, the ryles tube is inserted into the pouch and then roll around at the cavity. Next,, the sponge is cut according to the wound size and is covered on top of the ryles tube. FInally, everything is wrapped up with op-site to secure the position and make sure there is no room for air entry.

At last, the ends of the ryles tube is attached to the suction tubing. And suction pressure is turned to 150mmHg. Alas, the wound has turned into a vacumm state. The Vacumm assisted closure (VAC) done..

Pus is drained out immediately. Initially, patient will feel the pressure and tightness but as he get used to it , i can increase the pressure up to 200mmHg. Hence, this is the end of the procedure. This vacumm assisted dressing can last for a week and then if the wound is clean, we can opposed it with secondary suturing with KIV split skin graft or change another VAC until the wound is totally clean with granulation tissues.

I think the total cost price of the whole procedure is 50x cheaper than the high tech machines..
The most economical method i ever done...
SATISFACTORY....
And i keep looking at the patient's leg the whole evening and looking at the successful intervention that i did for the day..
Ohh... goody..