Wound Debridement and VAC Placement

Procedure Snapshot

• Indication: Necrotic or infected wound requiring source control.
• Expected duration: ___
• Special instruments: Curettes, knife, suction, VAC system.

Step Workflow

1. Prep entire region; anesthetize.
2. Excise all non-viable skin/subcutaneous tissue until bleeding edges.
3. Irrigate copiously with saline.
4. Apply VAC sponge to fit wound cavity; seal with adhesive drape.
5. Connect to negative pressure (-125 mmHg continuous).

Key Pimp Questions

• Q: Mechanism of VAC? Increases perfusion, granulation, reduces edema (PMID 31584092).

Critical Anatomy

• Depends on site — avoid exposed tendon or vessels.

Informed Consent Highlights

• Bleeding __ Pain __ Need for repeat debridement ___

Post-op Considerations

• Change dressing q48–72 h; nutrition optimization.

References

• Chassin’s, Soft Tissue. Clinical Scenarios, Wound Care.
• Argenta 2019 (PMID 31584092).