Draining fluids from a wound can be an important part of wound healing. However, it is just one of several clinical components of Negative Pressure Wound Therapy (NPWT). Wound drainage cannot provide the clinical benefits of NPWT. This Therapy delivers multiple mechanisms of action in order to help promote wound healing:

-          Removes infectious material

-          Removes fluids

-          Helps draw wound edges together

-          Helps protect the wound environment

-          Helps promote perfusion

-          Promotes a moist wound healing environment

The V.A.C.^® Therapy Unit, when used with its specialized dressings, is the only system that delivers the advanced wound healing benefits of NPWT.

2.       Gauze or foam dressings.  Is there a difference?

Yes, there is a clinical difference.  Although the V.A.C.^® GranuFoam^® Dressing (black foam) may seem like simple surgical foam, it has been specifically engineered to deliver NPWT. The hydrophobic, open pore structure of V.A.C.^® GranuFoam^® Dressings adapt to the contours of deep or irregularly shaped wounds in order to provide equal distribution of pressure at the wound site.  These open pores are also manufactured under specifications to achieve a 400-600 micron pore size to help promote wound healing.

For these reasons, gauze will not provide the proven benefits of NPWT, and, in some cases, the pooling of fluids may occur and interfere with the wound healing process.

3.    What is the difference between the black foam and the white foam?

The black foam (polyurethane, or GranuFoam^® Dressing) is hydrophobic or water repelling. It is an open pore foam, which allows for exudate to be removed. It is less dense than the white foam (polyvinyl alcohol, or Vers-Foam™ Dressing) and is reticulated, which means all the pores are in communication with each other. This design allows for increased distribution of negative pressure across the wound bed.

The white foam (polyvinyl alcohol, or Vers-Foam™ Dressing) is hydrophilic or moisture retaining. It is also an open pore foam, which allows for exudate to be removed. It has a higher tensile strength and is ideal for use in tunnels and shallow undermining. It also is pre-moistened with sterile water and is relatively non-adherent, making it beneficial for use on tendons, exposed hardware and exposed bone. It also is good for extremely painful wounds, shallow wounds and patients who are experiencing rapid granulation tissue growth.

4.  Is the V.A.C.^® Dressing change a clean technique or sterile technique?

V.A.C.^® disposables (canister, dressing and tubing) are sterile when received by the facility. Dressing applications regarding clean or sterile technique are completely physician/clinician preferences. A clinician has the option of applying the dressings in the OR utilizing a sterile/aseptic technique, if needed. He or she also has the option of using clean technique for placement such as in the home, or for pathologies that do not require sterile technique. As with all dressings that are packaged sterile, the options for use lie with the protocols and institutional policies regarding wound care. 

5.  Can you treat more than one wound with one therapy unit?

Yes! KCI has established two methods for connecting wounds to one therapy unit: “Bridging” and “Y-connecting.” Bridging can be accomplished when you have multiple wounds of similar pathology in close proximity to one another. You simply place the V.A.C.^® drape on the intact skin between wounds and place a strip of foam from one wound bed to the other over the draped skin. As long as all pieces of foam are touching each other, you can place the tubing in a central location and use one pump to distribute pressure throughout all the wounds. Y-connecting allows you to treat multiple, non-infected wounds, that are a larger distance apart by using a connector that can support two separate tubing connections. Therapy in either situation is evenly distributed across the wounds, yet controlled by one pump.

6.  Is there currently a CPT code that can be used to bill for application of V.A.C.^® Dressings?

Effective January 1, 2005, Negative Pressure Wound Therapy (NPWT) was assigned two CPT codes for wound treatment by the American Medical Association (AMA):

CMS changed the payment status in the 2006 Medicare Physician Fee schedule to "A" (active status) for the NPWT CPT codes.  CMS assigned 0.55 work Relative Value Units (RVUs) to code 97605 and 0.60 work RVUs to code 97606.  Relative Value Units are used to calculate the payment to providers.  This means that healthcare practitioners such as MDs, PTs, PAs, DPMs and NPs, who prescribe V.A.C.^® Therapy may be eligible for reimbursement for certain covered services related to NPWT.  Healthcare practitioners who are eligible to seek reimbursement under the NPWT CPT codes are determined by state regulations that dictate what types of procedures each practitioner can perform.   The dollar amount of the payment will vary, depending on the geographic location within the US and practice costs within that location.  It is approximately $30.00 for 97605 and $40.00 for 97606.