Wound V.A.C.® and Hyperbaric Oxygen Therapy – A Clinical Practice Guideline

woundvacWound V.A.C.® or Negative pressure wound therapy (NPWT) is an essential part of any comprehensive wound care and hyperbaric center. Many wound & hyperbaric centers encounter multiple patients on V.A.C.® therapy on a daily basis. Surprisingly I have found that many centers do not have a policy on what to do with a wound V.A.C.® prior to placing the patient in the chamber. KCI (the leading manufacturer of negative pressure wound therapy NPWT) has published their clinical practice guideline with 2 options on how to address the complexities of placing a patient in a Hyperbaric chamber that is on wound V.A.C.® therapy. Click here to view.

For those that are concerned about the V.A.C.® dressing materials and the polyurethane foam that comprises the bulk of the dressing here is an article on the material evaluation for hyperbaric exposures. The conclusion to this evaluation is: Both polyurethane foam and polyester/silicone NPWT dressings were demonstrated to be safe with regard to cytotoxicity and autoignition when placed into typical therapeutic hyperbaric oxygen environments.

V.A.C.® is a registered trademark of Kinetic Concepts, Inc. (KCI) is a global medical technology company with leadership positions in advanced wound care, negative pressure wound therapy (NPWT) and Therapeutic Support Systems.


Can this dressing go into the 100% oxygen filled chamber?

Critical Thinking Guy_colorThis is a question that plagues new and inexperienced HBO techs on a daily basis and immediately after the Florida accident some have gone to extremes of removing all medical related dressings and skin barriers prior to HBOT, of course you cannot be too safe right? Well, not really. You do run the risk of making the patients wounds worse by drying it out and exposing it to the atmosphere.

After digging thru all my safety books and manuals, I did find something that did relate to this particular subject in the “Hyperbaric Medicine Practice” 2nd edition by Dr. Kindwall (pp. 417). FULL ARTICLE CLICK HERE.

Here is a little bit of what it says:
….traditional practices of excluding certain types of dressings should be revisited. Vaseline gauze dressings are permitted in the monoplace chamber and have been used for many years without incident. A good practice is simply to cover them during treatment. If a patient with severe psoriasis, for example, requires a lotion or cream with a petroleum base to control the skin eruption, it is counter-productive and harmful to the patient to scrub away all the medicament on a daily basis prior to HBO.

Here is what not to do in any chamber – like myth busters without a brain.

idYou have to see these videos and just laugh, laugh loud. Has anyone ever thought of doing this in a 100% oxygen enriched chamber while in it? I hope not!

For those that cannot access the videos; these videos are of two males in a collapsible plastic chamber with 30% oxygen in the atmosphere at 1.3 or 1.4 ATA lighting various items on fire while inside of the chamber. It was hard to beleive at first (still is actually) but it looks pretty real to me.
Geniuses video 1
Geniuses video 2

Michael Jacksons video denial regarding sleeping in a hyperbaric chamber

If I got a dollar for every time a patient asked me about MJ sleeping in the chamber I would be rich. If I got a dollar for each time I’ve seen a negative press article about MJ and the chamber I would be richer. So now let’s clear it up once and for all!!! In 1993 Oprah interviewed MJ on video for her show and MJ denied sleeping in the chamber. So my answer to anyone would be “NO” Michael Jackson did not sleep in the chamber! As for those in the press, please do your research-it’s really easy, try http://www.google.com or if you only work by fax, telex, Western Union, or by phone I’m sure they will send you what they have for a small fee.
Here is the article and the transcripts from the interview:

(Notice the top right side of the hyperbaric chamber. The chamber door is shut but the cam locking device is not latched and engaged. The chamber will not compress unless this is engaged. Although this does not prove that he did not sleep in the chamber, it does prove that he “posed in a chamber” that was not at any pressure). As far as proving that he never slept in the chamber I would actually just take his word for it – what choice do we have right?