The VAC has been chugging away for 72 hours and has been collecting a fair amount of exudate. It’s now time for it’s first change and it’s going to be done in the comfort of my own home by a district nurse.
‘Oh, I Have Done One of these in Years!’
The nurse arrived with a student in tow and had given me some notice as requested so that I could have a shower (my first in a week!). I was hoping that the nurse that was being sent would be familiar with VAC dressings but whilst the nurse had changed a VAC dressing in the past, it was way in the past and she wasn’t familiar with this particular VAC. I was going to have to try and guide her along.
The Sticky Tape
Large strips of sticky tape are used to help maintain the vacuum seal and when applied it looks like your butt has been wrapped in cling film. Plenty had been applied in the hospital followed by two nurses adding more to fix a leak and an extra bit by myself so there was a lot to take off. Being a hairy person I was expecting it give me a butt wax in the process of being removed but surprisingly it was painless.
Oh God the foam! The foam consisted of 3 pieces that had been cut to fit the size of the wound and wedged into it, and I mean really wedged into it. When it was first applied I wondered how it would come out and whether there would be any pain.
With all of the tape and other dressing removed, the foam was left exposed and excruciating pain shot through my body. The foam wasn’t budging easily and on closer inspection it appeared that it had become stuck to the wound and as soon as it was moved blood started to appear along with the searing pain.
I could sense the nurse wondering how this was going to pan out. I too was wondering how it was going to pan out. I was in a position where we had gone too far into the process so could just decide to go to the hospital to ask them to change it.
She continued to try to remove it but with each little movement the pain was awful. She tried applying water but that made little difference. As it was in contact with an open wound you couldn’t quickly pull it out like you would quickly remove a plaster but it reached a point where rather than stopping each time I felt pain we’d have to plough on and keep pulling until all of the pieces were out.
For the next dressing we used gauze to pack it instead of the foam and when you have gauze as an option I don’t know why you’d use the foam. I’m hoping that when the VAC is changed again in 3 days I don’t have to go through the same pain.
Reapplying the Sticky Tape
The sticky tape that is applied to the area is a bit different to regular tape. It comes in sheets which can be cut to size and is a little confusing as there are a few different parts to the tape so you remove one part, apply, remove another part, apply, and then remove the final piece. This flummoxed the nurse at first, as did how best to apply it and the size of each bit.
Once fully sealed up (hopefully), a small hole was made for my tail to be fitted. This was also taped above my butt to try and ensure that it doesn’t kink and cause a leak or blockage.
The Moment of Truth
With the dressing fitted and the tube attached, would the machine be able to maintain a tight seal? We connected the pipe and powered up the Butt Machine. It checked for leaks and passed and began to deliver therapy. Whilst it was working I’m not convinced that the tape has been applied well enough and just an hour after being changed I could hear a hissing noise indicating a small leak, although the machine hasn’t detected it.
VAC Dressings and Nurses
From my very limited exposure to the world of VAC dressing, it does appear that they’re not used too often and as a result there doesn’t appear to be much training of nurses. I’ve had two nurses in two days and one had no experience of them and the other hadn’t seen one in quite some time. And in that time the machines and types of dressings have changed. Both nurses were grateful that I was able to assist them with my limited knowledge.
I guess if you don’t experience these types of dressings often then you tend not to train for them but then when you randomly get assigned one, it becomes difficult for the nurse and the patient is left feeling like the dressing may not have been applied in the best way.