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Wound care team teaches new type of therapy by Cindy Abole Public Relations It's Monday morning and MUSC's wound care nurses Pam Srinivas and Lynette Franklin are making the rounds visiting patients and nursing staff throughout the Medical Center. This familiar twosome are the resident experts in wound, ostomy and continence care. Their days are busily spent helping staff care for patients with large surgical wounds and chronically ill patients suffering from pressure ulcers or diabetic patients with open wounds on their legs or feet. Care for these patients can be challenging involving much attention and numerous dressing changes. Today, these specialists have brought their knowledge and skills to adult and pediatric nursing teams by training them  in the latest wound care techniques using an advanced technology known as Wound Vacuum Assisted Closure (V.A.C.) Therapy. Wound V.A.C therapy or negative pressure wound therapy was developed by physicians at Wake Forest University in 1995. It uses negative pressure through a controlled suction device  to close large wounds and promote faster healing. This patented, FDA-approved device is composed of a sophisticated pump, hoses and monitoring system held within a portable compact case weighing less than 20 pounds. At its beginnings, MUSC served as a Beta test site for the V.A.C. Therapy device. Today, it is recognized as an advanced line therapy alternative for patients where traditional dressing changes are not effective. It is a method that is  considered among recovering patients in hospitals, nursing homes and other home health care settings. It meets the needs of most cost-effective modalities and an estimated 5 million American patients suffering from chronic or acute wounds. “V.A.C. therapy is an example of a technical wound care product that uses advanced technologies,” said Srinivas, R.N. “Unlike other therapies, it promotes accelerated closure of an open wound.” Srinivas and Franklin teach an hour-long Wound V.A.C. Therapy course in September and October. Their program includes a detailed presentation, hands-on practice and demonstration of V.A.C. changes, short evaluation and door prizes for participants. Much of their programs are taught as introduction sessions or therapy updates in the mornings to staff and between early evening shifts. Seminars are open to physicians, nurses and ancillary staff—hospital managers, case managers, new students and residents and personnel serving intensive care units, oncology surgery, oncology and other areas.  Just recently, the Transitional Care Unit (TCU) team at Charleston Memorial Hospital were rewarded with a staff pizza party on Nov. 8 for best staff attendance during a training session held in September. “We wanted to conduct our training in a fun, relaxed way,” said Franklin, about the healthy competition between staffs. “Its use with TCU patients is a good example of how Wound V.A.C. Therapy has successfully helped in the healing process.” Srinivas and Franklin consider their staff roles as educators and resources to the people they've reached. Both are certified to care for ostomy patients and other forms of wound care. Their primary role is to educate staffs and empower them in the latest patient care techniques. “What's encouraging is that after these seminars, practitioners are excited to apply these techniques on the floor,” said Franklin. “There's an excitement to see others smile and say 'Look what I did!' I feel proud that they can brag for themselves. They've learned something that can help them take care of their patients better. It's so encouraging.” Franklin is the newest member to the ET nurses and wound, ostomy and continence team. She recently completed a nine-week certification program at Emory University, one of six institutions in the U.S. accredited by the Wound, Ostomy and Continence Nursing (WOCN) Society's Education Program, a professional, international nursing group with 3,700 members. Nurses in this specialty are required to undergo recertification every five years.  While Wound V.A.C. therapy has been widely used by trained practitioners for years, it has only been used sparingly at Lowcountry hospitals due to costs, proper training and acceptance by staff support when other traditional efforts have failed.  Ideally, this therapy promotes more of a team approach to patient care. First, a physician calls the wound care team to assess if a patient can be a candidate for V.A.C. therapy. They look at important criteria including wound size, duration of the wound,  presence of necrotic tissue (live/dead tissue), patient's condition and costs for care. Next a trained nurse would receive a Wound V.A.C. kit which would include the polyurethane foam dressings, adhesive dressing, tubing and V.A.C. unit. Nurses and nursing technicians are trained to assess the wound during the healing process and respond to an audible warning that prompts any needed adjustments to the dressing or machine.  “It's exciting to give nursing techs a new skill that allows them to work in partnership with the nursing staff,” said Srinivas. “It empowers them to help monitor the machine and assess changes that are helpful to the nursing staffs.” According to Srinivas, V.A.C. therapy can be used to promote healing over every organ except the brain. However, V.A.C. therapy cannot be used on fistulas (organs that possess an unnatural communications between each other such as communication between the rectum and bladder) or patients with cancer. Looking ahead are other technologies that are just as effective and fall in the same category but awaiting FDA approval.  Next year, KCI, the unit's manufacturer, will unveil a smaller version of the Wound V.A.C. called the mini Wound V.A.C., which weighs less than 3 pounds. and can be worn over the shoulder or waist to help manage smaller wounds.  For more information, contact Srinivas at 792-3233.