PRODUCT FOCUS

One of the most fascinating features ofthe human body is its ability torepair damaged tissue, and the

subsequent complex set of events that occur upon injury to the skin (Russell andEvans, 1999).

Chronic wounds often contain devitalizedtissue, which is often referred to as slough oreschar. Debridement is defined as the removalof devitalized or contaminated tissue which isadjacent to a traumatic or infected wound,until the surrounding healthy tissue isexposed. This may also include the removal offoreign material that has become embedded inthe wound (Dorlands Electronic MedicalDictionary, 1998). Within chronic wounds,debridement relates to the removal of necrotictissue (Miller, 1996).

Debridement is necessary in order to allowthe wound to be fully assessed and graded(Vowden and Vowden, 1999), and has alsobeen regarded as one element in the healingprocess (Fowler and Van Rijswijk, 1995).

In some wounds, debridement and tissuerehydration (essential in aiding debridementand promoting autolysis), may be consideredinappropriate, and therefore should only becarried out after careful wound and patientassessment.

VACUTEX™

All wounds are different and they are oftenlocated in difficult areas, hence the hugerange of wound management products avail-able (Hallet and Hampton, 1999).

VACUTEX™: a dressing designedfor patients, tailored by nurses

Michelle Deeth, Lucy Pain

AbstractVACUTEX™ is a new rapid capillary action dressing comprising threelayers: two 100% polyester filament outer layers, and a 65% polyesterand 35% cotton woven inner layer. The outer surfaces are fused in such a way as to prevent micro fibres shedding within the wound bed. No twowounds are alike, and wounds are often located in difficult-to-dressareas. This article will describe how VACUTEX™, when used withcreativity, addresses many of the challenges of wound management.

268 BRITISH JOURNAL OF NURSING, 2001, VOL 10, NO 4

Michelle Deeth is ClinicalNurse Specialist, TissueViability, and Lucy Pain isResearch Nurse, TissueViability, Glenfield Hospital,University Hospitals ofLeicester NHS Trust,Leicester

The VACUTEX™ capillary dressing, manu-factured by Protex Capillary Dressings Ltd, isa three-layer, non-woven/woven, low-adher-ent dressing, which comprises 100% poly-ester filament outer layers, 65%/35%poly/cotton fibres.

The layers are fused in such a way as to prevent micro fibres from the dressing shed-ding on to the wound bed. The non-wovenouter layers are able to transport and liftnecrotic and sloughy tissue using a capillaryaction. The polyester and cotton woven innerlayer prevents strikethrough by allowingwound debridement to move across the dressing, utilizing its capillary action. Theinner and outer layers combine to draw theexudate away from the wound surface, there-by reducing the risk of infection by removingharmful bacteria and preventing macerationof the wound.

Many dressings have the ability to absorb wound exudate and debris, butVACUTEX™ has the capacity to ‘pull’ exu-date and interstitial fluid from the woundbed and transport it initially to the centrallayer of the dressing, and then onward to thethird layer of the dressing.

VACUTEX™ therefore, draws unwantedexudate/necrotic tissue and slough from thewound, providing a clean environment forhealing to commence. This is achieved via anaccelerated capillary action. The dressingoffers protection and insulation for thewound, while maintaining a warm and moistenvironment.

The construction of the dressing allows flu-ids to travel just below the surface and alongand across the material, thus preventing exu-date from coming into contact with anypotentially macerated wound edges.

VACUTEX™ is soft and conformable, pro-viding pain-free application and removal. Thedressing can be applied in layers, dependingon exudate levels needing to be removed. Ifexudate levels are high, VACUTEX™ can beused in multiple layers to contain wound exu-

Product Focus 30/4/01 2:22 pm Page 1

VACUTEX™dressings need

to be cut andindividually tailoredto each wound andwound type, thusenabling healthcareprofessionals tomake a realcontribution to theideal dressing foreach patient...capillary actiondressings are a cost-effective woundmanagement productas they can oftenremain in place for longer than other dressings.

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date. Each extra layer will draw the contentsof the first layer through the various layersapplied. The dressing will retain its integrityeven when saturated.

VACUTEX™ dressings need to be cut andindividually tailored to each wound andwound type, thus enabling healthcare profes-sionals to make a real contribution to theideal dressing for each patient.

Russell and Evans (1999) suggest that cap-illary action dressings are a cost-effectivewound management product as they can oftenremain in place for longer than other dress-ings. VACUTEX™ is priced at up to 30% lessthan other modern wound management prod-ucts (Protex Capillary Dressings Ltd pricinglist, November 2000). Randomized compara-tive trials on the use of VACUTEX™ as awound debridement are currently beingundertaken in the UK and USA.

CASE STUDY 1

Mrs A is a 76-year-old woman who was diag-nosed with breast cancer and admitted for aleft breast mastectomy. Following surgery,dehiscence of the wound occurred after theremoval of the clips. Three days later, surgicaldebridement of the wound was performed bythe consultant, who then referred Mrs A tothe tissue viability team for advice on woundmanagement.

The initial assessment showed the woundbed to be 80% sloughy, with 20% granula-tion tissue present. Large amounts of serousfluid were leaking, and therefore the tissueviability nurse recommended VACUTEX™ tobe used. The advantage of usingVACUTEX™ is its ability to absorb highamounts of exudate while debriding thewound bed by utilizing its accelerated capil-lary action, creating a ‘drawing’ effect.Day 1: The wound measured 20 cmlength x 10 cm width. VACUTEX™ was cutinto a 1 cm wide ribbon and packed looselyinto the wound. For extra absorption, twofurther sheets of VACUTEX™ were placedover the wound and secured with tape(Figure 1).Day 8: VACUTEX™ was changed daily forthe first 7 days. The wound bed had signifi-cantly improved, with 95% granulation tis-sue and 5% slough present. The width nowmeasured 8 cm. The VACUTEX™ dressingwas containing the exudate well (Figure 2).

BRITISH JOURNAL OF NURSING, 2001, VOL 10, NO 4 269

Figure 1. The initial wound before dressing

with VACUTEX™.

Figure 2. Wound progress 8 days after using

VACUTEX™.

Figure 3. Wound progress 15 days after using

VACUTEX™.

Figure 4. Wound during the fourth week.

VACUTEX™: A DRESSING DESIGNED FOR PATIENTS, TAILORED BY NURSES

Product Focus 30/4/01 2:22 pm Page 2

The wound presented as a large and sloughycavity in very close proximity to the stomasite. The ward staff referred the patient to thetissue viability team for wound managementadvice. VACUTEX™ capillary action dressingwas recommended to aid the debridementprocess and absorb the high exudate levels. Day 1: Figure 5 shows the wound before usingVACUTEX™. It measured 25 cm length, 8 cmwide and 3 cm depth with 40% sloughy tissuepresent. VACUTEX™ was changed daily forthe first 7 days. The dressing was cut intosmall circles, each layer increasing in size andbuilt up to fit the lower part of the wound,ensuring close contact with the wound bed.Day 8: The wound had reduced in depth andshowed visible signs that the VACUTEX™

dressing had debrided the wound debris andslough (Figure 6).Day 15: The exudate levels had reduced consid-erably, requiring dressing changes on alternatedays only. Figure 7 demonstrates the decrease inwound size when compared with Figure 5.Day 22: The upper part of the wound mea-sured 10 cm x 2 cm and was full of healthygranulation tissue. The lower wound onlyhad a small area of slough to the wound bed,with majority of granulation tissue present(Figure 8).

Day 15: Dressing changes took place on alter-nate days. Mrs A found the dressing comfort-able and was able to maintain her indepen-dence. The depth of the wound had reducedfrom 2.5 cm to 1 cm. The wound bed washealthy, with 100% granulation tissue present (Figure 3).

The wound was photographed in thefourth week (Figure 4). The VACUTEX™

dressing was able to contain the wound exu-date for a minimum of 3 days, while prevent-ing maceration of the wound edges and sur-rounding skin.

Mrs A was discharged to a community hos-pital 41⁄2 weeks after surgical debridement.The wound at this point measured18 cm x 5 cm, and was superficial in depth.

Mrs A expressed that, since using theVACUTEX™ dressing, she felt confident theodour and exudate were managed so effec-tively that she was able to integrate withother patients and her family.

CASE STUDY 2

This case study is of a 55-year-old lady, MrsB, who had been admitted to hospital toundergo a Hartmann’s procedure. As a resultof slow postoperative recovery she remainedin the intensive care unit (ITU) for 4 days. Shewas then discharged from the ITU to one ofthe surgical wards in the hospital. On thetenth postoperative day, the sutures wereremoved from her abdomen, which led towound dehiscence.

270 BRITISH JOURNAL OF NURSING, 2001, VOL 10, NO 4

PRODUCT FOCUS

Figure 5. The initial wound before dressing

with VACUTEX™.

Figure 6. Wound progress 8 days after using

VACUTEX™.

The nursingstaff were

amazed with theimprovement of thewound in such ashort time, and oncethey were familiarwith VACUTEX™

they found it easy to design individualpatient woundmanagement....with the use ofVACUTEX™

dressings, an idealenvironment forwound healing is commenced. Its method ofapplication andremoval isnurse andpatient friendly.

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Product Focus 30/4/01 2:22 pm Page 3

BRITISH JOURNAL OF NURSING, 2001, VOL 10, NO 4 271

BJN

The nursing staff were amazed with theimprovement of the wound in such a shorttime, and once they were familiar withVACUTEX™ they found it easy to designindividual patient wound management.

These case studies have presented a newdressing product that provides an ultimatewound healing environment. The case studiesshow that with the use of VACUTEX™ dress-ing, an ideal environment for wound healingis commenced. Its method of application andremoval is nurse and patient friendly.

DISCUSSION

The advent of clinical governance and theestablishment of the National Institute forClinical Excellence means that healthcarestaff have to demonstrate research/evidence-based treatment and the efficacy of patientcare and cost-effective interventions(Newton, 1999).

Cost-effective management of wounds is acomplex matter, and should not only focuson short-term costs to healing, but also thelong-term costs (Roberts, 1998). Therefore,with the huge array of wound dressingproducts available, it is essential thathealthcare professionals base any dressingchoice decisions on what they know to be

clinically effective, incorporating good clin-ically tested evidence.

CONCLUSION

These case studies describe the benefits ofVACUTEX™ capillary action dressing,demonstrating the rapid wound debridementand improved healing rates.

Published results from current clinical stud-ies will be available from March 2001.

VACUTEX™ is available from Protex CapillaryDressings Ltd, 16/17 Bottings Industrial Estate,Botley, Hampshire SO30 2DY. Tel: 01489 780807or e-mail www.vacutex.net

Dorlands Electronic Medical Dictionary (CD-ROM)(1998) Anderson DM, ed. 28th edn. WB Saunders,London

Fowler E, Van Rijswijk L (1995) Using wounddebridement to help achieve the goals of care.Ostomy Wound Management 41(7A Suppl):235–365

Hallet A, Hampton S (1999) Wound Dressings.Wound Care Society Educational Leaflet. TheWound Care Society, Huntington, Cambridge

Miller M (1996) The role of debridement in woundhealing. Community Nurse 2(9): 52–5

Newton H (1999) Improving wound care in clinicalgovernance. Nurs Stand 13(29): 51–6

Roberts C (1998) Wound management products: theevidence we need and the difficulties in obtaining it.Journal of Tissue Viability 8(2): 12–15

Russell L, Evans A (1999) Drawtex: a unique dressingthat can be tailor made to fit wounds. Br J Nurs8(15): 1002–6

Vowden KR, Vowden P (1999) Wound debridement,part 1: non-sharp techniques. Journal of WoundCare 8(5): 237–40

VACUTEX™: A DRESSING DESIGNED FOR PATIENTS, TAILORED BY NURSES

Figure 7. Wound progress 15 days after using

VACUTEX™.

Figure 8. The wound after 22 days,

demonstrating decrease in wound size.

KEY POINTS

■ VACUTEX™ is aunique wounddressing, designedfor patients, buttailored by nurses.

■ When used withcreativity,VACUTEX™

addresses many of the challenges of woundmanagement.

■ The dressing hasthe ability to absorbexudate up to 30 times its own weight.

■ VACUTEX™ is a cost-effectivewound managementproduct.

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