Negative pressure wound therapy, (eg, vacuum assisted drainage collection), utilizing disposable, non-durable medical equipment including provision of exudate management collection system, topical application(s), wound assessment, and instructions for ong
CPT4 code
Name of the Procedure:
Negative Pressure Wound Therapy (NPWT) - Commonly known as Vacuum-Assisted Closure (VAC) therapy.
Summary
Negative Pressure Wound Therapy (NPWT) is a medical procedure that uses a vacuum pump to create a controlled negative pressure environment in a wound, promoting faster healing. This is achieved using disposable, non-durable medical equipment, which includes a collection system for wound exudate and topical applications.
Purpose
NPWT is designed to manage complex wounds by promoting tissue growth, removing exudate, reducing swelling and bacterial load, and enhancing blood flow to the affected area.
Indications
- Chronic wounds (e.g., diabetic ulcers, pressure sores)
- Acute wounds (e.g., trauma, partial-thickness burns)
- Surgical wounds with complications
- Wounds with heavy exudate
- Skin grafts and flaps
Preparation
- Patient should follow specific wound care instructions provided by the healthcare team.
- Diagnostic tests or wound assessments may be conducted to determine the suitability of NPWT.
Procedure Description
- Wound Preparation: The wound is cleaned and debrided if necessary.
- Application: A sterile foam dressing is cut to fit the wound and applied. A transparent adhesive drape covers the foam and the wound edges to create an airtight seal.
- Vacuum Connection: Tubing is connected from the foam dressing to the vacuum pump unit.
- Vacuum Activation: The vacuum pump is turned on to apply controlled negative pressure to the wound.
Tools/Equipment:
- Foam dressings
- Transparent adhesive drapes
- Vacuum pump unit
- Tubing
No anesthesia or sedation is typically required.
Duration
Application of NPWT takes about 30 minutes. The therapy is continuous or intermittent over days to weeks, depending on the wound.
Setting
NPWT can be performed in various settings including hospitals, outpatient clinics, and even at home with portable units.
Personnel
- Wound care specialists
- Nurses
- Physicians
Risks and Complications
Common Risks:
- Skin irritation
- Pain at the wound site
Rare Risks:
- Bleeding
- Infection
- Tissue necrosis
Benefits
- Accelerated wound healing
- Reduced infection risk
- Improved blood flow
- Decreased wound size and exudate
Patients may begin to notice benefits within days to weeks.
Recovery
- Regular dressing changes (as often as prescribed)
- Monitoring of wound healing progress
- Follow-up appointments for assessment and management
Alternatives
- Standard wound care: dressing changes and topical agents
- Surgical debridement
- Hyperbaric oxygen therapy
Pros and cons vary; NPWT is often chosen for its effectiveness in complex wound healing.
Patient Experience
During:
- Mild discomfort or pressure as the vacuum is applied.
After:
- Minor pain or irritation; managed with prescribed analgesics.
- Regular visits for dressing changes and wound assessments.