Negative pressure wound therapy (eg, vacuum assisted drainage collection), utilizing durable medical equipment (DME), including topical application(s), wound assessment, and instruction(s) for ongoing care, per session; total wound(s) surface area greater
CPT4 code
Name of the Procedure:
Negative Pressure Wound Therapy (NPWT), also known as Vacuum-Assisted Closure (VAC) Therapy.
Summary
Negative Pressure Wound Therapy (NPWT) is a medical procedure that uses suction to promote wound healing. A special vacuum device is applied to the wound area to help remove fluids and infections, reduce swelling, and encourage tissue growth.
Purpose
NPWT helps to manage complex wounds by:
- Removing excess fluid and infectious materials.
- Reducing swelling and enhancing blood flow.
- Promoting the growth of healthy new tissue.
Indications
NPWT is indicated for:
- Chronic wounds (e.g., pressure ulcers, diabetic foot ulcers).
- Acute and traumatic wounds.
- Surgical wounds that require delayed primary closure.
- Skin grafts and flaps.
Preparation
- No special preparation is usually required.
- The healthcare provider may assess the wound and surrounding skin and may perform necessary diagnostic tests like blood tests to check for infection.
Procedure Description
- Wound Assessment: The wound is first cleaned and assessed.
- Topical Application: Topical wound care products may be applied to the wound bed.
- Application of Dressing: A foam or gauze dressing is placed into the wound.
- Sealing: A clear, adhesive drape is placed over the dressing to create an airtight seal.
- Connection of Device: The dressing is connected to a vacuum pump via tubing.
- Activation: The pump is activated to apply negative pressure to the wound.
Tools used:
- Foam or gauze dressing.
- Adhesive drape.
- Vacuum pump and tubing (DME).
Duration
The procedure typically takes around 30-60 minutes per session.
Setting
NPWT can be performed in various settings including:
- Hospitals.
- Outpatient clinics.
- Home healthcare settings.
Personnel
The procedure is usually performed by:
- Wound care nurses.
- Physicians specialized in wound care.
- Sometimes, trained home healthcare professionals.
Risks and Complications
- Skin irritation or damage from adhesive drape.
- Pain during dressing changes.
- Risk of infection if improperly applied or managed.
- Bleeding, especially in patients on anticoagulant therapy.
Benefits
- Accelerated wound healing.
- Reduced wound size.
- Decreased risk of infection.
- Enhanced tissue growth. Improvements are often seen within a few weeks of consistent therapy.
Recovery
- Regular dressing changes as advised by the healthcare provider.
- Keep the wound and device clean and dry.
- Follow-up appointments to monitor wound healing.
- Patients may resume normal activities as tolerated but avoid strenuous actions that might disrupt the dressing.
Alternatives
- Standard wound care: cleaning and dressing changes.
- Surgical interventions for severe wounds.
- Hyperbaric oxygen therapy. Each alternative has different benefits and risks, and the choice depends on the wound's nature and patient's overall health.
Patient Experience
During the procedure, patients might feel slight discomfort or pain when the dressing is applied or changed. The vacuum pump might create a mild suction sensation. Pain management strategies, including over-the-counter pain relief medications, can be provided to ensure comfort during and after the procedure. Patients are encouraged to stay hydrated and report any unusual symptoms to their healthcare provider immediately.