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VSD Operation and Principle (III)

If the VSD material broken and wound exposed, how can we fix that?

Answer: Drainage tube can be fixed with bandage after operation, in order to avoid drainage tube twist and semi-permeable membrane torn induced by patient movement. Patients can be fixed with plaster during internal and external fixation. If there is injury, wound surface should be immediately covered, in order to avoid infection. If necessary, please change VSD material under sterile condition, and take vacuum aspiration again. 

Is negative pressure maintained at good condition?

Answer: If the collapsed VSD materials are recovered, there is effusion under film, indicating failure negative pressure. If some VSD materials become harden, vacuum drainage tube is closed temporarily. If VSD materials are recovered, it indicates existence of negative pressure. If VSD material still collapses, it indicates existence of effusion, indicating failure negative pressure or blockage of drainage tube for VSD materials. It needs to change dressing or wash tubes, etc. 

Can drainage tube be washed after VSD treatment?

Answer: Under normal condition, if negative pressure maintained at good condition, and drainage is smooth, please take specific treatment. If drainage tube is blocked, please take 

Can vacuum suction be temporarily closed?

Answer: If there is specific condition, clipper or relevant instrument can be sued to close drainage tube for a certain time. Please connect, if necessary, to avoid untimely drainage caused by wound secretion. 

Does it need to change VSD materials, if there is foul smell?

Answer: Because of little necrotic tissues and exudates residues, VSD care materials is smelly through the semipermeable membrane, and VSD care materials looks yellow-green, green pus, dark or other dirty color, but it is not caused by necrotic tissues at wound surface, and it cannot affect clinical efficacy of VSD. After carefully observing condition of VSD negative pressure, it does not need to take specific treatment under good vacuum sealing. It needs to differentiate with wound necrosis or sever infection. 

What should be observed and recorded during VSD treatment?

Answer: During VSD treatment, medical staffs should pay attention to following conditions besides of observing patient’s vital signs. 

1. Is pressure of negative pressure source in specific range (-125mmHg to -450mmHg; -0.017 to -0.08 MPa).

2. Is VSD material collapsed, or is negative pressure effective?

3. Is lots of fresh blood aspirated? Please take transparent suction bottle and suction tube to observe characteristics and volumes of drain.

4. Is drain smooth, in order to avoid blockage?

How to examine air leakage area, if there is air leakage on VSD surface?

Answer: Common air leakage areas were at mesentery sealing part of drainage tube or buckle fastening nail, T-junction part, the area with lots of exudates but not having negative pressure, skin fold, or the area without past due to irregular pasting. Press ear close to semi-permeable membrane and find the air leakage point, or pinch susceptible points to observe whether there is air leakage points. You should find the reasons of air leakage, and corresponding treatment should be taken. 

Is there complication for longer pasting time of semi-permeable membrane?

Answer: In general, there is without skin injury for pasting thin membrane on normal skin within 10 days. But some patients are with tension blisters on skin areas pasted with thin membrane, and seldom are with folliculitis. As pasting thin membrane, tension blisters can be avoided without stretching local skin excessively. Folliculitis are mainly found in the part with effusion for a long time or repeatedly pasted with thin membrane. Effusion under thin membrane should be avoided and treated immediately. The same place should not be pasted with thin membrane repeatedly, and the skin should be cleared as changing drainage tube. It is an effective method to prevent from folliculitis. Even if there is folliculitis, it can be cured after removing thin membrane. 

Is it normal with drain in drainage tube?

Answer: There is without drainage of drain, which is commonly found at about 4 days after operation (be determined according to wound condition). As drainage tube is smooth, and negative pressure source is normal, if there is without drain, it may be the normal condition that there is less secretion after wound healing. 

Is it necessary to take bacterial culture of wound excretion during VSD treatment? How to do?

Answer: Bacterial culture is the routine method for surgical treatment. It can effectively observe the condition of infection. Proper antibiotics can be selected according to results of drug allergy, and it is good for anti-infection treatment of server wound injury. It is not necessary to open VSD materials as extracting wound excretion, which can be extracted through drainage tube. After extracting, conventional iodine disinfection was taken for drainage pipe interface. And if necessary, the extraction can be carried out when replacing the VSD materials.