Procedure: NPWT Dressing Application

British Columbia Provincial Nursing Skin & Wound Committee

Procedure: NPWT Dressing Application - VACVia

Note: This is a controlled document. A printed copy may not reflect the current, electronic version on the CLWK Intranet. Any document appearing in paper form

should always be checked against the electronic version prior to use; the electronic version is always the current version. This DST has been prepared as a guide

to assist/support practice for staff working in British Columbia; it is not a substitute for proper training, experience & exercising of professional judgment

January 2021 1

Developed by the British Columbia Provincial Nursing Skin & Wound Committee in collaboration with NSWOCs & Wound Clinicians from:

Title

Procedure: NPWT Dressing Application – VACVia

Document

Indications

for Use

This Negative Pressure Wound Therapy (NPWT) dressing procedure is used with the disposable

3M/KCI VACVia machine/device and in conjunction with the Guideline: Negative Pressure Wound

Therapy (Reusable/Disposable) for Adults & Children.

British

Columbia

Practice

Level

 In order to carry out NPWT, Registered Nurses (RNs), Registered Psychiatric Nurses (RPNs),

and Licenced Practical Nurses (LPNs), in accordance with the British Columbia College of Nurses

and Midwifes’ scope of practice for their specific designation, must:

o Have Health Authority (HA) and/or agency policy in place to support their designation in

providing NPWT.

o Have a HA approved NPWT decision support guideline.

o Successfully complete the additional education for monitoring/managing the NPWT system.

o Successfully complete additional education for NPWT dressing application.

o Have client specific NPWT orders from a Physician/NP/NSWOC/Wound Clinician.

o For LPNs, follow an established NPWT wound treatment plan.

 Clients undergoing NPWT require an interprofessional approach to provide comprehensive,

evidence-based assessment and treatment.

Background

VACVia is a single-use, 7-day disposable system used for open wounds and skin grafts (not closed

incisions):

o Has a disposable 250 mL canister to be used for wounds with anticipated small to moderate

exudate, for anticipated larger exudate amounts, choose an alternative NPWT machine.

o The Pressure Therapy Is either 75 or 125 mmHg (unit of pressure) and the Therapy Setting is

either continuous (C) or dynamic pressure control (DPC).

o The dressing is changed a minimum of three (x 3) times weekly.

o Uses NPWT foam and woven PHMB gauze or ribbon packing as wound fillers. Meshed no-

adherent contact layers can be used as interfaces to protector fragile structures e.g., tendon.

o For disposal, the machine and batteries should be recycled as electrical or electronic

equipment.

General Safety Considerations for NPWT Medical Devices

 Defibrillation: when defibrillation is required in the area of the NPWT dressing, remove the

dressing or place the paddles in an alternate position; ensure that the NPWT machine is at least 2

meters away from the paddles.

 Electrodes or Conductive Gel: do not place EKG or other electrodes/conductive gels in contact

with the NPWT dressing/machine.

 Magnetic Resonance Imaging (MRI) environment:

o The NPWT machine itself cannot go into the MRI environment. If a canister is present,

disconnect it from the machine and ensure that all tubing clamps are open to allow any

exudate to flow into the canister.

o If the NPWT dressing (interface and/or foam) does not contain silver, then the dressing may

remain in place. If the MRI is to be done in the area of the wound, consult Radiology

Department regarding the need to remove the dressing.

o If the NPWT dressing is comprised of a silver-based interface or Granufoam Silver foam or is

a Prevena dressing, consult with the MRI Radiology Department; depending upon the MRI

magnetic field environment, the silver-based dressing may need to be removed.

 Diagnostic Imaging: Silver-based interfaces, Granufoam Silver foam or Prevena dressings may

impair visualization with certain imaging modalities; consult with the Radiology Department

regarding the need to remove the dressing.

 Hyperbaric Oxygen Chamber environment: the NPWT dressing should be removed and a different

type of dressing used for the duration of the HBO treatment period.

 Cell phones or similar products could affect the NPWT machine; move the NPWT machine away 2

meters (6.5 feet) away from the machine if interference is suspected.

 Do not connect NPWT dressings to wall suction.

Bookmarks

Equipment and Supplies

British Columbia Provincial Nursing Skin & Wound Committee

Procedure: NPWT Dressing Application - VACVia

Note: This is a controlled document. A printed copy may not reflect the current, electronic version on the CLWK Intranet. Any document appearing in paper form

should always be checked against the electronic version prior to use; the electronic version is always the current version. This DST has been prepared as a guide

to assist/support practice for staff working in British Columbia; it is not a substitute for proper training, experience & exercising of professional judgment

January 2021 2

Bookmarks

con’t

Procedure: Applying / Reapplying NPWT VACVia Dressing

Procedure: Removing the NPWT VACVia Dressing

Procedure: Changing the Canister

Managing VACVia Alerts / Alarms

Client Showering

Transition/Discharge Planning

Client/Family Education and Resources

Documentation

Bibliography/References

Document Creation

Documents

Guideline: Negative Pressure Wound Therapy (Reusable/Disposable) for Adults & Children

Guideline: Wound Management for Adults & Children

Procedure: Wound Cleansing

Procedure: Wound Packing

Additional Education Requirements/Competencies: NPWT Monitoring/Managing

E-Learning Module: NPWT Monitoring/Managing

Additional Education Requirements/Competencies: NPWT Dressing Application (under development)

E-Learning Module: NPWT Dressing Application (under development)

Documentation Tool: NPWT Safety/Monitor Check Flow Sheet

Client Health Education Resource (CHER): NPWT VACVia

Equipment and Supplies

VACVia 7-Day Dressing Kit contains:

 VACVia machine with a built-in 7 day-life rechargeable battery and AC power cord/ battery charger,

3 medium black spiral foam dressing kits (TRAC pad, transparent film drape, barrier wipe, ruler)

2 - 250 mL exudate canister (order replacement canisters as needed), carrying case and lanyard

Dressing Change Supplies

 Personal protective equipment (i.e., safety glasses, gloves, gown, and mask as required)

 Major dressing tray

 Sterile normal saline at least 100 mL, at least at room temperature

 Sterile scissors

 Sterile gloves - 1 pair

 Clean gloves - 2 pair

 Foam tip measuring probe or metal probe or cotton tipped applicator

 Alcohol swab(s)

 Procedure pad(s)

 Skin film barrier wipe

 Camera

 Pen or Marker

Pre-Soak Supplies (for wounds only)

 50-60 mL syringe – syringe type is depended upon Pre-Soak Method #1 or #2 (see pg. 8)

 Sterile normal saline at least at room temperature

 Clean gloves - 1 pair

 1 sterile 4 x 4 dressing (to keep the NPWT canister tubing end sterile, if caps not available)

 Sterile scissors

 Alcohol swab(s)

 Procedure pad(s)

 Lidocaine 1% (without epinephrine), if ordered

Additional Supplies as pre the Pre-Printed Order (PPO) or in the written care plan.

 Sterile PHMB woven gauze roll or ribbon packing

 Meshed non-adherent contact layer

 Sterile hydrocolloid or extra transparent film drape

 Adhesive remover

 Non-sterile ostomy strips, rings, paste, if needed for filling in folds and creases.

British Columbia Provincial Nursing Skin & Wound Committee

Procedure: NPWT Dressing Application - VACVia

Note: This is a controlled document. A printed copy may not reflect the current, electronic version on the CLWK Intranet. Any document appearing in paper form

should always be checked against the electronic version prior to use; the electronic version is always the current version. This DST has been prepared as a guide

to assist/support practice for staff working in British Columbia; it is not a substitute for proper training, experience & exercising of professional judgment

January 2021 3

Procedure: Applying / Reapplying a NPWT VACVia Dressing

Click here for Procedure: Removing a VACVia Dressing

Steps

Key Points

1. Review the Orders:

 Read the NPWT order and overall care plan.

 Review allergies/sensitivities to acrylic

adhesives/products.

The transparent drape has an acrylic adhesive

coating, which may present a risk of an adverse

reaction in client who are allergic or hypersensitive.

 Prepare the client:

 Assess client’s pain/anxiety for appropriate

medication(s) required and allow time for the

medication(s) to take effect.

 Position the client for the procedure.

The client undergoing NPWT may experience pain

and anxiety. Provide pain management strategies,

medications, education, reassurance and position for

comfort.

2. Set-up for the procedure:

 Gather the supplies.

 Perform hand hygiene; put on clean gloves.

 Set up the sterile dressing tray; designate

one side of the sterile field for cutting the

wound fillers/interface layers.

 Add the supplies needed for peri-skin

protection and any additional wound fillers.

 Ensure a permanent marker is available and

place outside the sterile field.

 Remove the current dressing.

 Remove gloves; perform hand hygiene and

don clean gloves.

Perform hand hygiene to avoid contamination.

Add all sterile supplies to sterile field. If using ostomy

rings, please note these are not sterile and should

added to the perimeter or edge of the sterile field.

3. Clip peri-wound/surrounding skin hair, if needed:

 Using scissors or clippers, clip the hair in the

area where the dressing is to be applied.

Clip as close to the skin surface as possible.

 Avoid shaving whenever possible.

Hair can make it difficult to achieve an airtight seal

and may cause pain during drape removal.

Shaving is not recommended as this can cause skin

irritation and may lead to folliculitis but, if needed,

then shave in the direction of the hair follicles.

4. Cleanse and assess:

Wound:

 Use a 15 cm foam tipped applicator, metal

probe or sterile cotton tip applicator to

explore the depth & direction of undermining,

sinus tracts/tunnels.

 Cleanse the wound and peri-skin with at least

100 mL of NS. Use moistened gauze and

forceps to remove loose slough/debris.

 Complete a full wound assessment.

 If taking photos for documentation, remove

gloves, perform hand hygiene, take photos &

then put on clean gloves.

Skin Graft:

 Cleanse the graft and peri-graft area with

Normal Saline as per Surgeon orders.

 Complete a full assessment.

 If taking photos for documentation, remove

gloves, perform hand hygiene, take photos &

then put on clean gloves.

If this is a dressing reapplication, determine the

If the undermining, sinus tract/tunnel end cannot be

probed (is beyond 15cm), do not irrigate or pack

these areas.

Cleansing the wound/incision/skin graft aids in

removal of exudate and promotes visualization of

wound bed tissues.

Cleansing the wound bed and peri-skin ensures all

loose hairs is removed and not retained in the

wound

Measurements taken provide an objective

assessment of wound healing. Measurements must

be compared to previous measurements to ensure

that wound healing is occurring, if this is the goal.

British Columbia Provincial Nursing Skin & Wound Committee

Procedure: NPWT Dressing Application - VACVia

Note: This is a controlled document. A printed copy may not reflect the current, electronic version on the CLWK Intranet. Any document appearing in paper form

should always be checked against the electronic version prior to use; the electronic version is always the current version. This DST has been prepared as a guide

to assist/support practice for staff working in British Columbia; it is not a substitute for proper training, experience & exercising of professional judgment

January 2021 4

Steps

Key Points

appropriateness of ongoing NPWT; if there are

any concerns, e.g. wound/graft deterioration,

notify the Physician/NP/NSWOC/Wound

Clinician.

5. Prepare the peri-skin and surrounding skin:

 Use sterile forceps to apply skin barrier wipe

to the peri-skin and surrounding skin, let dry.

 Use non sterile ostomy strips, rings, paste to

fill in any skin folds and creases.

If needed, the following may be done now,

wearing clean gloves, or later, once the transition

to sterile gloves is complete:

 Window-pane the wound or graft with a

hydro-colloid barrier (up to 5cm)

Skin barrier film wipe protects the skin from

adhesives, helps to maintain an airtight seal and

may extend the wear time of the dressing. Ostomy

rings, paste, or strips aid in levelling the peri-skin

and supports an airtight seal.

If the client/wound situation requires sterile

technique for all aspects of the dressing then

prepare the peri-skin once sterile gloves are donned;

otherwise can be done with clean gloves once the

wound and surrounding area is cleansed.

6. Transition to sterile technique:

 Remove clean gloves; perform hand hygiene.

 Open the NPWT VACVia dressing kit and

place the kit contents on the sterile field.

 Perform hand hygiene. Apply sterile gloves

for the remainder of the procedure.

Instruments used to clean the wound are no longer

sterile and therefore not used to aid in the activities

used to fill the wound bed.

7. Prepare the peri-skin and surrounding skin if not

already prepared (Step 6).

8. Prepare the interface layer(s), if being used:

 Wound: cut the layer to fit into the area

requiring protection.

 Skin Graft: cut the layer slightly larger than

the graft size area needing protection.

The interface layer must be meshed and can be

either a non-antimicrobial (i.e., silicone) or

antimicrobial (i.e., silver). White foam may also be

used to protect areas of concern (i.e., tendon).

9. Prepare the necessary wound filler(s):

 Black foam: cut to fit the wound depth. For

smaller wounds, ensure that the black foam

piece is cut greater than the TRAC pad size.

 White foam: cut the foam piece(s) to fit the

undermining/sinus tract/tunnel ensuring that

the foam piece is narrower at one end and/or

cut to fit the wound depth.

 PHMB gauze roll or ribbon: cut to length.

When cutting the wound filler(s) cut over the sterile

field and ensure loose particles of foam/gauze are

not retained in the wound bed.

10. Fill/pack wound dead space or cover graft area:

Wound:

 Start with the undermining/sinus/tunnel and

use one the following:

o PHMB gauze/ribbon: lightly fill/pack the

area, ensure to leave a 1 - 2 cm tail of

packing visible. If using PHMB gauze roll,

fold in the gauze edges in to keep the raw

edges off the wound bed.

o White foam: Lightly pack the narrow end

of the foam in the space until it reaches

the end of the sinus/tunnel. Pull back by

1 to 2 cm to ensure that the foam end is

visible in the wound cavity.

Fill/pack the undermined or sinus/tunnel to support

granulation but do not over-pack gauze or foam.

Filling/packing the space too tightly will cause

pressure on the new tissue.

White foam is recommended for use in undermining/

sinus/tunnel as it is denser and will not break when

removed. White foam is always cut wider at the end

that rests in the wound cavity, and is cut narrower at

the end that is placed in the undermining or

sinus/tunnel.

British Columbia Provincial Nursing Skin & Wound Committee

Procedure: NPWT Dressing Application - VACVia

Note: This is a controlled document. A printed copy may not reflect the current, electronic version on the CLWK Intranet. Any document appearing in paper form

should always be checked against the electronic version prior to use; the electronic version is always the current version. This DST has been prepared as a guide

to assist/support practice for staff working in British Columbia; it is not a substitute for proper training, experience & exercising of professional judgment

January 2021 5

Steps

Key Points

 If using, line the wound bed with an interface

layer:

o Lay down a non-adherent contact

(meshed) layer or white foam.

 Then fill/pack the wound cavity using one or

a combination of the following:

o White foam

o Black/silver foam: Ensure the foam size is

cut larger than the TRAC pad.

Skin Graft

 Lay the interface layer down ensuring all

sutures/staples are covered.

 Then lay down the foam piece(s).

The white foam/gauze must be visible in the wound

bed and to ensure it is removed when the dressing is

changed.

Where possible, place the manufactured edge of the

foam face-down on the wound bed.

White foam must always be covered with black foam

to support proper removal of exudate.

Ensure the top layer black/silver foam is cut larger

than the TRAC pad to prevent Medical Machine-

Related Pressure Injuries.

11. Ensure the fill/pack is compete:

 If more than one piece of foam/gauze is used

ensure that all foam and gauze edges are in

contact with each other. Wound fillers may

need to be overlapped.

 Ensure that the black foam is the final (top)

layer placed in the wound as the TRAC pad

must sit on the black foam:

o If, the wound is smaller than the TRAC

pad, ensure that the top layer is black

foam is cut larger than the TRAC pad

and the peri-skin protected.

o Ensure that the black foam is 2.5 cm

higher than the peri- skin level.

The entire wound surface must be covered with

wound filler(s) and all pieces must be in contact with

each other to maintain suction and the flow of

exudate.

Foam touching the peri- skin will cause skin irritation,

maceration or ulceration.

The TRAC pad must sit on the black foam to ensure

proper removal of exudate.

Filling to this height ensures the TRAC pad is resting

at skin level when vacuum is applied and not below

the skin surface.

12. Apply the NPWT transparent film drape:

 The transparent drape may be cut into strips

to make it easier to handle; cut the drape

before removing the backing layer.

 Remove the back Layer #1 and lay (do not

stretch) the drape over the foam and 3 to 5

cm of prepped or window-paned peri-skin.

 Gently press the transparent drape onto the

skin to ensure an airtight seal.

 Remove the top Layer #2 from the trans-

parent drape. Remove the blue strip/tabs

 Repeat these steps as needed.

 If using more than one piece of NPWT

transparent film drape, ensure that the edges

overlap to prevent air leakage.

Ensure transparent drape does not cover body

orifices, stomas, or drain openings.

Applying stretched film drape can lead to blistering

over the peri-skin.

Adding a small border of additional drape may

extend the dressing wear time.

Remaining transparent film drape pieces may be

used to patch any air leaks, if necessary.

13. Apply the TRAC pad:

 With sterile gloves, determine the best

position of the TRAC pad and drainage

tubing; do this in consultation with the client,

if possible.

 Cut at least a 2.5 cm round opening in the

transparent film drape over the foam.

 Remove TRAC pad layers #1 and #2 and

center it over the opening in the drape

The TRAC pad and draining tube positioning must

avoid boney prominences and skin folds; positioning

should allow for client comfort and ease of

performing ADLs.

Wound exudate passes from the wound through the

foam into the TRAC pad/tubing. If the drape opening

is cut is too small (i.e., with an ‘X’ or a ‘slit’) the

drape opening will close causing a blockage alarm.

British Columbia Provincial Nursing Skin & Wound Committee

Procedure: NPWT Dressing Application - VACVia

Note: This is a controlled document. A printed copy may not reflect the current, electronic version on the CLWK Intranet. Any document appearing in paper form

should always be checked against the electronic version prior to use; the electronic version is always the current version. This DST has been prepared as a guide

to assist/support practice for staff working in British Columbia; it is not a substitute for proper training, experience & exercising of professional judgment

January 2021 6

Steps

Key Points

 Apply gentle pressure to ensure the TRAC

pad rests fully on the foam. Ensure that it is

not touching any of the peri- skin. Then

gently pull gently on blue stabilization tab to

remove the top layer of the TRAC pad.

 Secure the TRAC pad tubing to the dressing

with an additional strip of transparent drape.

14. Prepare the NPWT machine:

 Remove sterile gloves.

 Install the rechargeable battery.

 Install the canister:

o Hold machine and canister in each hand.

o Slide the canister into the slot on bottom

of the machine. The upper locking tab will

‘click’ when canister is secured.

 Open the canister port cover and connect the

dressing tubing to the canister.

 Open the tubing clamp.

When needed, connect the machine to a power

source using the cord provided.

15. Start the therapy:

 Turn the machine ON by holding the ON/OFF

button for 3 seconds. 7 green ‘Therapy Life

Indicator Lights’ will be lit up.

 Hold the Pressure Therapy button (75 mmHg

or 125 mmHg) for 3 second to set the

prescribed setting. A green light will indicate

the Pressure Therapy chosen.

 Hold the Therapy Setting button (Continuous

or Dynamic Pressure Control) for 3 seconds

to choose the ordered Therapy. A green light

will indicate the Therapy Setting chosen.

The therapy life indicators provide a visual indication

of the 7-day therapy life cycle. After each 24-hour

period, one of the indicators will turn off.

If needed, see Managing VACVia Alerts/Alarms

16. Assess for an airtight seal:

 With an airtight seal the dressing will collapse

and have a wrinkled appearance, be firm to

the touch and no hissing sounds heard.

 If this is not the case, gently press down all

dressing areas and apply additional

transparent film drape to achieve a seal.

 If the TRAC pad needs to be repositioned on

the dressing, perform hand hygiene and

apply sterile gloves, then:

o Trim out the existing TRAC pad. Cleanse

with alcohol swab prior, if needed.

o Seal the original hole with drape.

o Wipe drape with alcohol swab (30+

seconds) and let dry prior to making a new

2.5 cm opening.

 Then reapply the TRAC pad and secure in

place using strips of sterile drape.

If the dressing does not collapse in less than 1

minute, there may be a dressing leak or tubing

blockage. Note: The vacuum effect of VAC Via is

slower than the reusable machines.

Repositioning is often done to aid in positioning and

performance of activities of living. Where possible do

in consultation with the client.

British Columbia Provincial Nursing Skin & Wound Committee

Procedure: NPWT Dressing Application - VACVia

Note: This is a controlled document. A printed copy may not reflect the current, electronic version on the CLWK Intranet. Any document appearing in paper form

should always be checked against the electronic version prior to use; the electronic version is always the current version. This DST has been prepared as a guide

to assist/support practice for staff working in British Columbia; it is not a substitute for proper training, experience & exercising of professional judgment

January 2021 7

Procedure: Removing a NPWT VACVia Dressing

Steps

Key Points

1. Review the chart:

 Read NPWT orders and overall care plan.

 Review the documented packing count.

2. Prepare the client:

 Assess client’s pain for appropriate medi-

cation(s) and allow time for the medication(s)

to take effect as needed.

The client undergoing NPWT may experience pain

and anxiety. Provide pain management strategies,

medications, and reassurance.

3. Set-up for dressing removal - Open Wounds only:

 Turn off the NPWT machine and clamp the

dressing tubing for at least 30 minutes prior to

dressing removal.

 If needed, do a NS pre-soak or a pre-soak

with Lidocaine 1% (without epinephrine) with,

or followed by, the same amount of NS using

one of the following pre-soak methods:

Pre-soak Method #1:

o Prepare a 50-60 mL Leur-lock syringe with

the solution.

o Disconnect the dressing and canister

tubing, keeping ends sterile with 4x4 gauze.

o Cleanse the connection with an alcohol

Black or silver foams are more likely to adhere to

the wound bed than white foam. Turning the NPWT

machine off releases the suction, allowing wound

exudate to collect on the wound bed which helps to

release the foam.

Incision and Skin Graft sites do not need the 30-

minute rest period or a pre-soak. The dressing can

be removed immediately after the machine is

turned off.

Use of Lidocaine 1% without epinephrine requires a

Physician/NP order. See the document bookmark

Lidocaine: Physician/NP Prescribing in the

Steps

Key Points

17. Clean up workspace:

 Discard the dressing tray and disposable

scissors.

 Remove gloves; perform hand hygiene.

18. Document on the dressing:

 Apply the documentation sticker (if available)

to the transparent drape.

 Document the number of interface(s) and

wound filler(s) on the dressing. The following

coding system may be used, if helpful:

o I for Interfaces

o G for Gauze

o W for White Foam

o B for Black Foam

o S for Silver Foam

 Write the date on the canister.

If documentation sticker not available, then write the

count on the dressing itself or on a piece of tape and

apply to the dressing.

Document the number of wound filler pieces after

each dressing change. It is critical to ensure that all

pieces are removed at the next dressing change.

19. Conduct the first Safety/Monitoring Check:

 Check the system from the dressing to the

power source to ensure that the system is

working correctly.

 Assess colour, movement, warmth, sensation

distal to the dressing if NPWT on a limb.

 If tubing is a falls risk, secure accordingly.

 Assess that battery is charging. Ensure

machine is plugged in.

VACVia Therapy is ON

The seven Therapy Life Indicator green lights are

visible each indicating one day of therapy; as the

therapy progresses there are fewer green lights on.

Once the therapy is turned ON for (1) continuous

hour, the 7-day lifespan of the machine begins, it

continues even if the unit is turned OFF.

Keep the machine plugged in as much as possible to

aid in charging the rechargeable batteries.

British Columbia Provincial Nursing Skin & Wound Committee

Procedure: NPWT Dressing Application - VACVia

Note: This is a controlled document. A printed copy may not reflect the current, electronic version on the CLWK Intranet. Any document appearing in paper form

should always be checked against the electronic version prior to use; the electronic version is always the current version. This DST has been prepared as a guide

to assist/support practice for staff working in British Columbia; it is not a substitute for proper training, experience & exercising of professional judgment

January 2021 8

Steps

Key Points

swab and let dry 30+ seconds.

o Connect the syringe to the dressing tubing.

o Slowly instill the solution into the dressing;

the dressing should budge slightly. If this

does not occur, add more plain NS.

o Remove the syringe and reconnect the

dressing tubing to the canister tubing.

o Let the solution rest in the dressing for at

least 20 to 30 minutes.

Pre-soak Method #2:

o Prepare a 50-60mL catheter tip or Toomey

syringe with the solution.

o Cleanse tubing 5 cm away from the

dressing. Use an alcohol swab and let dry

for 30+ seconds.

o Cut the cleansed TRAC pad tubing and

connect the syringe to the dressing tubing.

Guideline: Negative Pressure Wound Therapy

(Reusable/Disposable for Adults & Children for

dosage.

The pre-soak method, either #1, #2, or another

method, is to be determined through consultation

with Physician/NP/NSWOC/ Wound Clinician.

4. Prepare for the procedure:

 Gather supplies.

 Position client for the procedure.

 Clamp both tubing clamps.

 Disconnect dressing and canister tubing.

 If canister is to be reused, protect the dressing

tubing end using the protective cap, if

available. If not, use sterile gauze dressing.

 Perform hand hygiene; put on clean gloves.

 Set up a sterile dressing tray with NS.

See Equipment and Supplies List

5. Review packing count on the dressing:

 Check the NPWT dressing for the current

number of wound filler and interface

layers/pieces used with the previous dressing

change; ensure that this count matched the

packing count documented in the client’s chart.

Counts of the interface layer(s) and wound filler(s)

should match.

6. Remove the dressing:

 Anchor the drape with one hand; with the

other hand, gently lift the dressing horizontally

away from the wound, and slowly push the

skin away from the dressing. If drape not

releasing use an adhesive remover.

 Gently lift off the dressing.

 Count all the packing pieces to ensure all are

removed. If the count does not match, inform

Physician/NP.

A peeling motion can cause epidermal stripping

and irritates the peri-skin and surrounding skin.

Retained packing pieces can increase the risk of

wound infection. Report any packing miscounts in

the Patient Safety Reporting system.

7. Remove gloves; perform hand hygiene.

8. If changing the dressing within the 7-day life of the

machine, then see Procedure: Applying/

Reapplying a VACVia Dressing and connect the

dressing to the existing machine.

9. If machine has come to its 7-day end-date or the

NPWT has been discontinued, dress the wound/

incision/skin graft as per orders.

Recycle batteries where possible; the machine

should be recycled as electrical/electronic

equipment.

British Columbia Provincial Nursing Skin & Wound Committee

Procedure: NPWT Dressing Application - VACVia

Note: This is a controlled document. A printed copy may not reflect the current, electronic version on the CLWK Intranet. Any document appearing in paper form

should always be checked against the electronic version prior to use; the electronic version is always the current version. This DST has been prepared as a guide

to assist/support practice for staff working in British Columbia; it is not a substitute for proper training, experience & exercising of professional judgment

January 2021 9

Procedure: Changing a VACVia Canister

Steps

Key Points

 Gather supplies

o New sterile canister

o Alcohol swab x1

o Appropriate PPE

 Wash hands

 Turn the machine OFF by holding the ON/OFF

button for 3 seconds.

 Slide the dressing tubing clamp close to where

tubing plugs into canister. Close the clamp.

 Cleanse the tubing connector site with the

alcohol swab for 30+ seconds. Allow to dry for

30+seconds.

 Unplug tubing from canister tubing port. Keep

end sterile by wrapping in with the alcohol swab.

 Press down on canister tab to remove the

canister.

 Install a new canister and listen for a distinct

click to confirm it is in place.

 Reattach dressing tubing to canister port.

 Open the tubing clamp.

 Turn therapy on; hold ON/OFF button for 3

seconds.

 Date the canister.

Canister is to be changed when it is noted to be full

or when the solid yellow light over the blockage

symbol comes on with an audible beep which

repeats every 15 seconds. The alarm may be muted:

hold the Mute button for 3 seconds (this muting will

last 2 minutes).

When the canister is changed, the audible and visual

alarms will turn off. The green ‘Therapy Life Indicator

Lights’ will continue in its 7-day cycle.

Managing VACVia Alerts/Alarms

Note: All alarms may be muted by pressing the Mute button for 3 seconds; this muting will last 2 minutes.

Alerts / Alarms Display

Monitor / Manage

Therapy Complete:

 When the machine is at the last 8 hours of

therapy, the last Therapy Indicator will show both

a YELLOW light and a GREEN light.

 When the machine is ready to shut off, the last

GREEN light goes off, leaving the YELLOW

light. An alarm will sound of 8 beeps followed by

one beep for 5 seconds and then the machine

turns off.

Monitor for completion of the therapy.

Low Battery:

Solid yellow light with 2 beeps repeating every 4

minutes.

Alarm indicates approximately 2 hours of therapy

remain; plug in immediately to prevent disruption of

therapy.

Blockage / Canister Full:

Solid yellow light and an audible beep repeating

every 15 seconds.

 To ensure no blockages, ensure the tubing

clamp is open and the tubing is not kinked.

 If canister is full, then change canister.

Continue on next page

British Columbia Provincial Nursing Skin & Wound Committee

Procedure: NPWT Dressing Application - VACVia

Note: This is a controlled document. A printed copy may not reflect the current, electronic version on the CLWK Intranet. Any document appearing in paper form

should always be checked against the electronic version prior to use; the electronic version is always the current version. This DST has been prepared as a guide

to assist/support practice for staff working in British Columbia; it is not a substitute for proper training, experience & exercising of professional judgment

January 2021 10

Alerts / Alarms Display

Monitor / Manage

Air Leak:

Solid yellow light and an audible beep repeating

every 15 seconds

 Do not shut off the machine.

 Using your finger press along the edge of the

drape to find areas which are loose or have

lifted. Apply transparent film strips as needed.

 Ensure tubing connection is tight and that the

canister is securely locked on to the device.

 If the air leak is resolved, the audible beep will

stop and the yellow light will turn off. Note; there

will be a short delay as the machine senses that

the leak has been fixed or not. If not, the alarm

will sound, try again to seal the air leak.

 If unable to fix the leak, then apply alternative

dressing as per order. Notify the prescriber that

NPWT dressing has been removed.

Machine Failure:

All the lights will turn on and flash. Two beeps will

sound, repeating every 15 seconds.

 Try powering the unit on and off.

 Try changing the batteries.

 If machine is not working, obtain a new dressing

kit and attach the new machine.

 If a VACVIA dressing kit is not available, then

remove current dressing and apply alternative

dressing as per order. Notify Physician/NP/

NSWOC/Wound Clinician that NPWT dressing

has been removed.

3M/KCI Customer Service: Phone: 1-800-668-5403

Client Showering

For clients with a skin graft, showering/tub bathing should wait until the VACVia dressing has been

discontinued to avoid disturbing the dressing. Clients may have a sponge bath.

For clients with a wound, clients can shower but not have a tub bath. The shower needs to be taken

immediately prior to a scheduled dressing change and the shower time should be kept short.

Set up for the shower:

 Gather the supplies: alcohol swab, (2) 2x2 gauze dressings and tape.

 Turn the machine “Off”.

 Wash hands. Don gloves.

 Close the tubing clamp.

 Using the alcohol swab, cleanse the connection point of the dressing tubing and canister port for

30+seconds and allow to dry for 30+seconds.

 Disconnect the dressing tubing from canister port.

 Cover the end of the tubing with a 2x2 gauze/tape to keep it clean.

 Place the machine where it will not get wet.

 To avoid water getting into the tubing; ensure that the dressing tubing is positioned downward during

the shower.

 The dressing is waterproof but should not be exposed to direct shower spray. If necessary, cover with

a plastic sheet/tape.

 After showering:

o Gently pat dry the dressing and tubing.

o Reconnect the tubing.

o Open the tubing clamp.

British Columbia Provincial Nursing Skin & Wound Committee

Procedure: NPWT Dressing Application - VACVia

Note: This is a controlled document. A printed copy may not reflect the current, electronic version on the CLWK Intranet. Any document appearing in paper form

should always be checked against the electronic version prior to use; the electronic version is always the current version. This DST has been prepared as a guide

to assist/support practice for staff working in British Columbia; it is not a substitute for proper training, experience & exercising of professional judgment

January 2021 11

Transition/Discharge Planning Refer to Guideline Negative Pressure Wound Therapy for Adults & Children

 For transition between an acute site to another acute care site

 For transition between an acute care site to community care

 For transition between an acute care site to long-term care

 For transition between a community care site or a long-term care site to an acute care site

Client/Family Education and Resources

1. Acute Care:

a. When NPWT is started, teach patient/family the rationale for and the underlying principles of NPWT,

as well as, general information regarding the VACVia machine being used.

b. Prior to transition of care to Community (home/Ambulatory Care Clinic):

 Review the Client Health Education Resource: NPWT VACVia which outlines the frequently

asked NPWT-related questions and specific VACVia machine details e.g. the management of

alerts/alarms, changing the canister.

 Identify which method the patient is to use to manage an irreparable dressing leak and put

together the client’s Troubleshooting Supplies bag.

2. Community Care:

a. When the client is transitioned from Acute Care with NPWT in place or when the NPWT is started at

home/ambulatory clinic, teach/reinforce with client/family the rationale and underlying principles of

NPWT, as well as, review the frequently asked NPWT-related questions and specific information

regarding the VACVia machine being used, e.g. the management of alerts/alarms, changing the

canister; see Client Health Education Resource: NPWT VACVia.

 Review/identify the method that the client is to use to manage an irreparable dressing leak.

Ensure client has a Troubleshooting Supplies bag.

3. Long Term Care:

a. When the resident is received back from Acute Care with NPWT in place or when NPWT is started

within the long-term care site, teach/reinforce with client/family the rationale for and the underlying

principles of NPWT, as well as, general information regarding the VACVia machine being used.

Documentation

1. With each VACVia NPWT dressing change, document on the appropriate paper or electronic document-

ation tool, as per agency policy, and include the following:

a. The full wound assessment

b. The numbers (#) of interface and wound filler packing pieces removed and replaced

c. Document the client’s response to the dressing change.

2. Document NPWT clinical outcomes and care plan revisions as they occur.

3. For Acute Care & Long Term Care, document safety/monitoring checks on the NPWT Safety/Monitoring

Check Flow Sheet.

4. For Acute Care & Long Term Care, document canister fluid volume; use the Fluid Balance (In/Out) flow

sheets as per unit policy.

5. Document client/family teaching provided on transition of care and any Troubleshooting Supplies given

to client/ family on transition to the community setting.

6. When a VACVia NPWT dressing is applied/changed in the Operating Room (OR), the following is

documented in the OR record:

 NPWT type: Open Wound, Closed Incision or Skin Graft.

 Type(s) of pieces (black foam, white foam, interfaces) placed in or removed from the wound

cavity by the surgical team.

 Number of pieces placed in/removed from the wound cavity by the surgical team.

7. Report NPWT adverse events in the Patient Safely Learning System, or report the safety event according

to Health Authority or agency guidelines.

British Columbia Provincial Nursing Skin & Wound Committee

Procedure: NPWT Dressing Application - VACVia

Note: This is a controlled document. A printed copy may not reflect the current, electronic version on the CLWK Intranet. Any document appearing in paper form

should always be checked against the electronic version prior to use; the electronic version is always the current version. This DST has been prepared as a guide

to assist/support practice for staff working in British Columbia; it is not a substitute for proper training, experience & exercising of professional judgment

January 2021 12

Bibliography/References

1. Refer to the Negative Pressure Wound Therapy for Adults & Children Guideline for the master list of references.

2. KCI (An Acelity Company). (2018). V.A.C.VIA Negative Pressure Wound Therapy System Instructions For Use.

Retrieved from https://www.acelity.com/healthcare-professionals/instructions-for-use?country=united-

states&language=english. Drawings adapted from same.

Document Creation

This guideline is based on the best information available at the time it was published and relies on evidence and avoids

opinion-based statements where possible. It was developed by the Provincial Nursing Skin & Wound Committee and has

undergone provincial stakeholder review.

Created By

British Columbia Provincial Nursing Skin & Wound Committee in collaboration with NSWOCs/

Wound Clinicians from across all Health Authorities.

Publication Date

July 2019

Revision Date(s)

January 2020, May 2020, January 2021

Review Date(s)