WOUND VAC ORDER SET
COMMUNITY HOSPITALS AND WELLNESS CENTERS
WOUND VAC ORDER SET
Date and Time ______________
1. Cleanse with
Soap and water Saline Sterile water Wound wash
2. Periwound
No-sting wipe Duoderm VAC drape stoma paste stoma powder
3. Contact layer
Black Foam White Foam Mepitel
4. Cover Dressing
VAC drape Tegaderm Coban
5. Canister
Change once a week PRN full or alarming
6. Change
Every other day Monday, Wednesday, Friday Tuesday, Friday
PRN loose or alarming
7. Setting per manufacturer instructions
8. Other per manufacturer clinical guidelines
________________________________________________________________________
________________________________________________________________________
________________________________________________ Per order set
________________________________________________ MD
................
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