PULSED LAVAGE with suction (PLWS) is a wound debridement system used in a variety of health care settings to clean wounds. But because infection control precautions aren't included in the equipment package, patients can be exposed to serious Acinetobacter baumannii infections that are resistant to multiple drugs unless you observe special precautions. Such infections can have deadly results.
Because PLWS devices use pressure-pulsed irrigation to clean wounds, the devices can scatter infectious agents up to 8 feet. That's why it's so important to follow standard precautions, use personal protective equipment, and clean the treatment room between PLWS-treated patients. Here's what you can do to help keep your patients safe when using PLWS.
Taking precautions
Make sure you follow these rules when using PLWS devices.
PLWS device use and maintenance:
* Become familiar with all device instructions for use and optimal techniques to minimize contamination of the environment.
* Use continuous suction (one manufacturer recommends a setting of 60 to 100 mm Hg).
* Keep the splash shield in contact with the wound/periwound area at all times.
* Empty the suction waste canister after each patient use or as directed by the manufacturer.
* Dispose of all single-use pulsed lavage components, as appropriate, immediately after use. Thoroughly clean, then sterilize or disinfect, as appropriate, all reusable items.
Environmental controls:
* Always perform pulsed lavage in a private room enclosed with walls and doors (no privacy curtains or large open areas).
* Follow standard practices to minimize potential contamination of equipment and supplies. For example, allow only essential equipment in the treatment room and no open shelves or cabinets.
* After each patient treatment, thoroughly clean and disinfect environmental surfaces that are touched by hand.
* Minimize contamination by limiting direct contact with exposed surfaces during treatment. Consider covering those surfaces at greatest risk for aerosol contamination.
* Make sure the room is appropriately ventilated.
Personal protective equipment:
* Wear a fluid-proof gown, gloves, mask/goggles or face shield, and hair cover.
* Consider having patients use a droplet barrier, such as a surgical mask, during PLWS treatment.
* Use a drape or towel to cover all patient lines, ports, and wounds that aren't being treated.
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