1. Introduction

2. Preparation

a. Wound Swabs for Culture Samples

b. Measure Wound Dimensions and Take Pictures for Plastics

3. Removal of Foam and Sponges

a. Tissue Debridement and Hematoma Removal

4. Irrigation and Wound Cleaning

5. New Sponge Placement

6. Stapling Sponge to Wound Edges and Protecting Skin with Plastic Dressing

7. Application of Film Seal

8. Foam Bridge Creation for Best Positioning of Vacuum Suction

9. Application of Vacuum Suction

10. Post-op Remarks

Vacuum-assisted closure (VAC) is a method of wound management commonly employed as an adjunct to surgery that uses negative pressure to accelerate healing. This video is a comprehensive step-by-step demonstration of VAC change for a complex right hip wound. The patient is a male in his fourth decade with a history of paralysis beginning in childhood due to a spinal tumor. He was admitted to the hospital with a right hip joint infection complicated by methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia. Given his immobility at baseline, the patient was deemed a suitable candidate for a Girdlestone procedure, which involved resection of the femoral head and proximal aspect of the femur, resulting in a complex wound with exposed bone.

Watch this full-length, narrated video of a vacuum-assisted closure being changed for a complex hip wound.

Massachusetts General Hospital