After a traumatic injury, every touchpoint matters.
The choices you make at each care-delivery step require careful consideration of risks and outcomes. As you evaluate and care for burns, lacerations, open fractures, amputations and other traumatic wounds, we offer the support of our innovative products and world-class education — all backed by patient-centered science. Together, we can strive to reduce preventable complications, drive toward better outcomes and, ultimately, aspire to restore patients’ lives.
Traumatic wounds account for approximately 5.4% of all emergency department visits.¹
As you evaluate patients with traumatic wounds, consider the negative pressure wound therapy (NPWT) that best matches your treatment goals — from cleansing contaminated wounds to protecting open abdomens.
An integrated wound management system designed and clinically shown to create an environment that promotes wound healing. V.A.C.® Therapy has demonstrated in published studies the potential to help reduce hospitalization time and risk of complications.²,³
Veraflo Therapy combines the benefits of NPWT with automated instillation and dwell of topical wound solution to provide simultaneous cleansing and granulation tissue formation.
AbThera Therapy helps protect abdominal contents from the external environment, allows rapid access for re-entry, provides medial tension, and fluid removal. It helps to draw together wound edges and helps to achieve primary fascial closure.
The number of microorganisms with which an object is contaminated is referred to as the bioburden⁶. Susceptibility to therapy decreases as biofilm matures. Bioburden formation is commonly considered to occur in five main stages.⁷
A) Stage one: reversible attachment. Free-floating bacteria attach to surface.⁸
B) Stage two: permanent surface attachment. Bacteria can begin secreting matrix with 15 minutes of attachment.⁹
C) Stage three: protective matrix/biofilm. Bacteria replicate as fast as every 30 minutes¹⁰and biofilm characteristics appear within 5 hours.¹¹
D) Stage four: increasing tolerance to biocidesMature biofilm can be observed within 8 to 10 hours.¹¹,¹²
E) Stage five: reformation. Dispersion of bacteria from mature biofilms causes recolonisation.⁸
Wounds may be susceptible to contamination or the development of bioburden – key contributors to complications like infection, inflammation, and delayed healing. 3M™ Veraflo Therapy combines vacuum assisted drainage with automated topical wound solution distribution to cleanse and remove wound debris helping to reduce bioburden.
Following a boating injury, a 26-year-old female received a transfemoral amputation resulting in a soft tissue defect. During transportation to the facility, the patient had a Combat Tourniquet and received 13 units of packed red blood cells and eight units of fresh frozen plasma. The wound was surgically debrided and irrigated at different stages of the treatment. She received therapeutic plasma exchange, continuous renal replacement therapy after being diagnosed with macrophage activation syndrome, and V.A.C.® Therapy at -125mmHg. When surgical debridement was not an option, Veraflo Therapy was initiated using a V.A.C. Veraflo Cleanse Choice Dressing, instilling 100ml of 0.125% Dakin’s Solution to help remove devitalized tissue. As wound healing progressed, Veraflo Therapy was transitioned to using 3M™ V.A.C. Veraflo™ Dressing, instilling 80ml normal saline. After the tangential excision and split-thickness skin graft, it was covered with a non-adherent layer and bolstered using V.A.C.® Therapy applied at -125mmHg. Systemic antibiotics were administered throughout the patient’s treatment period.
A) Day 0 of Veraflo Therapy - Wound on Day 9 before initiating 3M™ Veraflo™ Therapy.
B) Day 4 of Veraflo Therapy – wound healing progressed.
C) Day 16 of Veraflo Therapy – Wound on day 25 with significant granulation tissue present and a considerable amount of coverage over the femur fragment.
As with any case study, the results and outcomes should not be interpreted as a guarantee or warranty of similar results. Individual results may vary depending on the patient’s circumstances and condition.
Read this (see page 18) and 11 other case studies (PDF, 996 KB)
A 33-year-old male amputee with history of tobacco use, anemia, and methicillin-resistant Staphylococcus aureus presented with an infection of above-the-knee stump. Conservative sharp debridement was performed at the bedside, and oral antibiotics were initiated. As the wound required further cleansing, Veraflo Therapy using V.A.C. Veraflo Cleanse Choice Dressing was started. Hypochlorous solution (80-100 mL) was instilled with a 10-minute dwell time, followed by 2 hours of negative pressure at -125 mmHg. Dressing changes occurred every three days. After nine days, Veraflo Therapy was discontinued, and V.A.C.® Therapy was initiated.
After he was struck by an automobile, a 37-year-old pedestrian required an emergency laparotomy showing massive bleeding from a grade IV liver injury. The patient developed severe bowel edema, so surgeons performed damage control and used AbThera Therapy for temporary abdominal closure (TAC).
3M™ AbThera™ Advance Perforated Foam was cut to the size and shape of the opening and was placed over the visceral protective layer. 3M™ V.A.C.® Drape and tubing were placed over the dressing to create a seal, and the tubing was connected to the AbThera Therapy unit. Early definitive abdominal wall closure reduced the risk of complications and the need for subsequent surgeries.
A) Application of AbThera Fenestrated Visceral Protective Layer.
B) AbThera Therapy was used for 9 days.
C) Definitive closure on Day 9.
Patient data and photos courtesy of Demetrios Demetriades, MD, PhD, FACS Professor of Surgery Director, Division of Acute Care Surgery, Los Angeles County and University of Southern California Medical Center, Los Angeles, CA.
As with any case study, the results and outcomes should not be interpreted as a guarantee or warranty of similar results. Individual results may vary depending on the patient’s circumstances and condition.
The 3M Wound Therapy Guide can help assist you in selecting a wound care solution for your patient based on the attributes and treatment objectives you choose. This guide is intended for use by clinicians in the United States for outpatient care.*
You may also view all treatment approaches without specific recommendations.
Discover online learning that's right for you and deepen your clinical expertise with training opportunities and educational resources available on 3M℠ Health Care Academy.
3M webinars and archived events can help keep you up to date with the latest product guidelines and scientifically supported standards of care.
When looking at real-world NPWT initiation at wound care centers (WCCs), approximately 60% of traumatic wounds (n=919) received early therapy — within the first seven days. Based on this data, WCCs have an opportunity to initiate 3M™ V.A.C.® Therapy earlier, potentially improving outcomes for more patients.
Based upon the meta-analysis by Allen Gabriel, MD et al.¹⁴ an economic model was developed to compare the cost of using Veraflo Therapy to traditional wound care options including V.A.C.® Therapy.
Despite higher therapy cost of Veraflo Therapy, the reduction in therapy time and required OR visits resulted in a potential savings of 50%, or up to $33,337 per patient.⁵
Note: The model uses select study data to provide an illustration of estimates of costs for use of Veraflo Therapy or Standard of Care (Control). This model is an illustration and not a guarantee of actual individual costs, savings, outcomes or results. The facility is advised to use this model as an illustration only to assist in an overall assessment of products and pricing.
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Incorporating evidence-based standards to infusion therapy can help protect against the factors that may lead to increased risk of bloodstream infection.
Following guidelines and best practices when caring for patients before, during and after surgery is critical to prevent post-surgical infection.
When pressure injuries can’t be avoided, establish a standard of care that treats the whole patient. 3M can help with solutions to support therapy goals established between you and your patients.
3M is committed to providing customer service, including product reimbursement education and resources, to clinical providers and healthcare facilities that use qualified 3M products.
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1. Prevaldi C, et al. Management of traumatic wounds in the Emergency Department: position paper from the Academy of Emergency Medicine and Care (AcEMC) and the World Society of Emergency Surgery (WSES). World J Emerg Surg. 2016 Jun 18;11:30.
2. Law A L Krebs B. Karnik B. Griffin L. Comparison of Healthcare Costs Associated With Patients Receiving Traditional Negative Pressure Wound Therapies in the Post Acute Setting. Cureus 12(11): e11790. DOI 10.7759/cureus.11790.
3. Page JC, Newsander B, Schwenke DC, Hansen M, Ferguson J. Retrospective analysis of negative pressure wound therapy in open foot wounds with significant soft tissue defects. Adv Skin Wound Care/ 2004;17(7):354-364.
4. "Baharestani MM. Driver VR. Optimizing clinical and cost effectiveness with early intervention of V.A.C.® Therapy. Ostomy Wound Manage. 2008;54(11 Suppl):1-15.
5. Kim PJ, Lookess S, Bongards C, Griffin LP, Gabriel A. Economic model to estimate cost of negative pressure wound therapy with instillation vs control therapies for hospitalised patients in the United States, Germany, and United Kingdom. International Wound Journal. 2022 May;19(4):888-894.
6. Bjarnsholt T, Eberlein T, Malone M, Schultz G. Management of wound biofilm made easy. London: Wounds International 2017; 8(2).
7. A fact a day – biofilms and wound care. Wound Source. 2018. Available at: https://pages.woundsource.com/woundsource-practice-accelerator-biofilms-and-wound-care/.
8. Costerton JW, Stewart PS, Greenberg EP. Bacterial Biofilms: A Common Cause of Persistent Infection. Science. 1999; 284 (5418):1318-1322.
9. Davies DG, Geesey GG. Regulation of the Alginate Biosynthesis Gene algC in Pseudomonas aeruginosa during Biofilm Development in Continuous Culture. Appl Environ Microbiol. 1995; 61(3):860-867.
10. Cicmanec F, Holder IA. Growth of Pseudomonas aeruginosa in Normal and Burned Skin Extract: Role of Extracellular Proteases. Infect Immun. 1979; 25(2):477-483.
11. Harrison-Balestra C, Cazzaniga BS, Davis SC, et al. A Wound-Isolated Pseudomonas aeruginosa Grows a Biofilm In Vitro Within 10 Hours and Is Visualized by Light Microscopy. Dermatol Surg. 2003: 29(6):631-635.
12. Schaber JA, Triffo WJ, Suh SJ, et al. Pseudomonas aeruginosa Forms Biofilms in Acute Infection Independent of Cell-to-Cell Signaling. Infect Immun. 2007; 75 (8):3715-3721.
13. Miller-Mikolajczyk C, James R. Real world use: comparing early versus late initiation of negative pressure wound therapy on wound surface area reduction in patients at wound care clinics. Poster presented at The Wound Ostomy and Continence Nurses Society Annual Conference, June 22-26, 2013. Seattle, Washington.
14. Gabriel A, Camardo M, O'Rorke E, Gold R, Kim PJ. Effects of Negative-Pressure Wound Therapy With Instillation versus Standard of Care in Multiple Wound Types: Systematic Literature Review and Meta-Analysis. Plastic and Reconstructive Surgery. 2021 Jan 1;147(1S-1):68S-76S.
15. Cicmanec F, Holder IA. Growth of Pseudomonas aeruginosa in Normal and Burned Skin Extract: Role of Extracellular Proteases. Infect Immun. 1979; 25(2):477-483.
16. Harrison-Balestra C, Cazzaniga BS, Davis SC, et al. A Wound-Isolated Pseudomonas aeruginosa Grows a Biofilm In Vitro Within 10 Hours and Is Visualized by Light Microscopy. Dermatol Surg. 2003: 29(6):631-635.
17. Schaber JA, Triffo WJ, Suh SJ, et al. Pseudomonas aeruginosa Forms Biofilms in Acute Infection Independent of Cell-to-Cell Signaling. Infect Immun. 2007; 75 (8):3715-3721.