Download Untitled
Transcript
INSTRUCTIONS FOR USE ABThera™ SensaT.R.A.C.™ Open Abdomen Dressing Only for use with Negative Pressure Therapy provided by InfoV.A.C.®, V.A.C.® ATS or V.A.C.Ulta™ Therapy Units PRODUCT DESCRIPTION TheABThera™SensaT.R.A.C.™OpenAbdomenDressing,whenusedwithNegativePressureTherapy providedbytheInfoV.A.C.®,V.A.C.®ATSandV.A.C.Ulta™TherapyUnitsprovidesanactivetemporary abdominalclosuresystem,designedtoremovefluidsfromtheabdominalcavityanddrawwound edgestogether,helpingtoachieveprimaryfascialclosurewhileprotectingabdominalcontents fromexternalcontaminates. SAFETy INFORMATION IMPORTANT:Aswithanyprescriptionmedicaldevice,failuretoconsultaphysicianandcarefully readandfollowalltherapyunitanddressinginstructionsandsafetyinformationpriortoeachuse mayleadtoimproperproductperformanceandthepotentialforseriousorfatalinjury.Donot adjusttherapyunitsettingsorperformtherapyapplicationwithoutdirectionsfrom/orsupervision bytheclinicalcaregiver. AlldisposablecomponentsoftheABThera™SensaT.R.A.C.™OpenAbdomenDressingareforsingle useonly.Re-useofdisposablecomponentsmayresultinwoundcontamination,infectionand/or failureofthewoundtoheal. INDICATIONS FOR USE TheABThera™SensaT.R.A.C.™OpenAbdomenDressingisindicatedfortemporarybridgingof abdominalwallopeningswhereprimaryclosureisnotpossibleand/orrepeatabdominalentries arenecessary.Theintendeduseofthisdressingisinopenabdominalwoundswithexposedviscera including,butnotlimitedto,abdominalcompartmentsyndrome.Theintendedcaresettingisa closelymonitoredareawithintheacutecarehospital,suchastheICU.Theabdominaldressingwill mostoftenbeappliedintheoperatingtheater. CONTRAINDICATIONS • Neverplaceexposedfoammaterialdirectlyincontactwithexposedbowel,organs,blood vesselsornerves.ProtectvitalstructureswiththeVisceralProtectiveLayerat all timesduring therapy. • Patientswithopenabdominalwoundscontainingnon-entericunexploredfistulasshouldnotbe treatedwiththeABThera™SensaT.R.A.C.™OpenAbdomenDressing. Managementoftheopenabdomenhasbeendocumentedincasereportsandconsensuspanel literature.PleaserefertotheReferences Listsectionofthisdocument. WARNINGS Not for use with Instillation Therapy: Although it is accepted medical practice to flush a contaminatedopenabdominalcavitywithsalineorothermedicalsolutions,theABThera™ SensaT.R.A.C.™OpenAbdomenDressingwasnotdesignedforthispurpose,andKCIhasnostudies tosupportitssafeandeffectiveusewithinstillationtherapy.Potentialrisksofinstillationintothe openabdomeninclude: • Instillationoffluidintheabdomenwithoutsufficientfluidrecoverymayleadtoabdominal compartmentsyndrome. • Instillationoffluidsintheabdomenthatareuntestedforsafetyandefficacywiththisapplication couldleadtoseverehollowviscusandsolidorgandamage. • Non-suturedhemostaticagents(forexample,bonewax,absorbablegelatinspongeorspray woundsealant)appliedintheabdomenmay,ifdisrupted,increasetheriskofbleeding.Protect againstdislodgingsuchagents. • Infectionintheabdominalwoundmayweakenvisceralorgansandassociatedvasculature, whichmayincreasesusceptibilitytobleeding. • Useofanticoagulantsorplateletaggregationinhibitors. • Bonefragmentsorsharpedgescouldpuncturevesselsorabdominalorgans.Bewareofpossible shiftingintherelativepositionoftissues,vesselsororganswithintheabdominalwoundthat mightincreasethepossibilityofcontactwithsharpedges. Intra-abdominal Pressure Monitoring:Laparotomywiththeplacementofanytemporary abdominalclosuredoes noteliminatethepossibilityofelevationinintra-abdominalpressure (IAP).WhenusingNegativePressureTherapy,IAPmonitoring(forclinicalordiagnosticsignsand symptomsofelevatedIAP)shouldcontinueasindicatedbypatientconditionandinaccordance withinstitutionalclinicalpracticeorguidelines.Ifintra-abdominalhypertension(IAH)orabdominal compartmentsyndrome(ACS)isobservedorsuspected,noteintra-abdominalpressuresand turnoffpowertotheNegativePressureTherapyUnit,discontinuingnegativepressure.Afterfull expansionoftheperforatedfoam,obtainanewintra-abdominalpressuremeasurement.IfIAH /ACSpersistswithoutnegativepressure,discontinuetheuseofNegativePressureTherapyand addresstheunderlyingconditionasmedicallyindicated. • Multiplelayersofthedrapemaydecreasethemoisturevaportransmissionrate,whichmay 1. RemovecontentsfrominnerpouchandunfoldtheVisceralProtectiveLayerinasterilefield. EithersideoftheVisceralProtectiveLayermaybeplacedontheomentumorviscera. 2. GentlyplaceVisceralProtectiveLayerovertheopenabdominalcavity(Fig. 1). 3. Determinetheorientationofthedressingforthespecificapplication.IfVisceralProtective Layerwillbeplacedaroundtubes,drainsorthefalciformligament,cutonlybetweenthefoam extensions(Fig. 2).Donotcutnearorthroughfoamextensions.OrienttheVisceralProtective Layeraccordinglybeforecutting. 4. SizetheVisceralProtectiveLayerbyfoldingorcuttingasdescribedinthefollowingsections. Folding Visceral Protective Layer to Size Fig. 3 discontinueuseandconsultaphysician. Dressing Removal:Thedressingcomponentsarenotbioabsorbable.Alwaysremovealldressing componentsfromtheabdomenateverydressingchange. duringdrapeapplication. DRESSING APPLICATION Cutting Visceral Protective Layer to Size Perforated Foam(2) VisceralProtective Layer(1) SensaT.R.A.C.™ Pad(1) Fig. 4 1. Holddressingbytheedgeandslightlylift.Slowlylowerdressingintotheparacolicgutter,using theotherhandtogentlyandevenlyworkthedressingdown(Fig. 3).FoldanyexcessVisceral ProtectiveLayerupandoverontoitself. 2. ContinueplacingVisceralProtectiveLayerbetweenabdominalwallandinternalorgans(Fig. 4) throughouttheabdominalcompartment.Thegoalistoensurefullcoverageofallviscera. ABThera™ SensaT.R.A.C.™ OPEN ABDOMEN DRESSING COMPONENTS Defibrillation:Removeadhesivedrapefromareaofdefibrillationtopreventinhibitionofelectrical energytransmission. Application Setting:Dressingapplicationsandchangesshouldbeperformedunderstrictsterile conditionsinthesurgicalsuite.Ifdressingchangeisperformedoutsidethesurgicalsuite,itmust beperformedinanenvironmentequippedtoaddresstheonsetofcriticalcomplications(referto WARNINGSsection)andwherestrictaseptictechniquecanbeutilized. Fig. 2 • Ifanysignsofirritationorsensitivitytothedrape,foamorSensaT.R.A.C.™Padtubingappear, IfthereareanyquestionsregardingtheproperplacementorusageoftheABThera™SensaT.R.A.C.™ OpenAbdomenDressing,pleasecontactyourlocalKCIclinicalrepresentative. Hyperbaric Oxygen Therapy (HBO):DonottaketheNegativePressureTherapyUnitinto ahyperbaricoxygenchamber.TheNegativePressureTherapyUnitisnotdesignedforthis environment,andshouldbeconsideredafirehazard.AfterdisconnectingtheNegativePressure TherapyUnit,either(i)replacethedressingwithanotherHBOcompatiblematerialduringthe hyperbarictreatmentor(ii)covertheunclampedendoftheSensaT.R.A.C.™Padtubingwithmoist cottongauze.ForHBOtherapy,thetubingmustnotbeclamped.Neverleaveadressinginplace withoutactivenegativepressureformorethantwohours;pleaserefertotheKeep Negative Pressure Onsection. Fig. 1 increasetheriskofmaceration. • Toavoidtraumatotheperiwoundskin,donotpullorstretchthedrapeoverthefoamdressing Bleeding:Patients with abdominal wounds must be closely monitored for bleeding as these wounds may contain hidden blood vessels which may not be readily apparent. If sudden or increased bleeding is observed in the dressing, tubing or canister, immediately discontinue Negative Pressure Therapy, take appropriate measures to stop bleeding, and contact the physician. Negative Pressure Therapy is not designed to prevent, minimize or stop bleeding. • Radiation Enteric Fistula or Leak:Whentreatinganopenabdomenwhereentericfistulasarepresent, cliniciansshouldconsiderthepotentialforabdominalcontaminationifeffluentisnotappropriately isolatedormanaged. Dressing Placement:Alwaysuseadressingfromasterilepackagethathasnotbeenopenedor damaged.Donotforceanydressingcomponentintothewound,asthismaydamageunderlying tissue. Magnetic Resonance Imaging (MRI) – ABThera™ SensaT.R.A.C.™ Open Abdomen Dressing: ThedressingcanremainonthepatientwithminimalriskinanMRenvironment,assumingthat useofNegativePressureTherapyisnotinterruptedformorethantwohours;pleaserefertoKeep Negative Pressure On section. • Trauma Spinal Cord Injury:Intheeventapatientexperiencesautonomicdysreflexia(suddenchanges inbloodpressureorheartrateinresponsetostimulationofthesympatheticnervoussystem), discontinueNegativePressureT0herapytohelpminimizesensorystimulation. Infection:Infectedabdominalwoundsshouldbemonitoredcloselyandmayrequiremore frequentdressingchangesthannon-infectedwounds,dependentuponfactorssuchaspatient condition,woundconditionandtreatmentgoals.Refertodressingapplicationinstructionsfor detailsregardingdressingchangefrequency. Acrylic Adhesive:Thedrapehasanacrylicadhesivecoating,whichmaypresentariskofadverse reactioninpatientswhoareallergicorhypersensitivetoacrylicadhesives.Ifapatienthasaknown allergyorhypersensitivitytosuchadhesives,donotusethedressing.Ifanysignsofallergic reactionorhypersensitivitydevelop,suchasredness,swelling,rash,urticariaorsignificantpruritus, discontinueuseandensureappropriateemergencymedicaltreatment.Ifbronchospasmormore serioussignsofallergicreactionappear,removedressingandensureappropriateemergency medicalinterventionasindicated. WARNING: The foam in the Visceral Protective Layer is encapsulated for patient safety. Protect vital structures with Visceral Protective Layer at all times during therapy. Never place exposed foam material directly in contact with exposed bowel, organs, blood vessels or nerves. Patient Size and Weight:Thesizeandweightofthepatientshouldbeconsideredwhen prescribingNegativePressureTherapy.Initiallowernegativepressureshouldbeconsideredfor certainsmallorelderlypatientswhoareatriskoffluiddepletionordehydration.Monitorfluid outputincludingthevolumeofexudateinboththetubingandcanister.Thistherapyhasthe potentialtoremoveandcollectlargevolumesoffluid.Tubingvolume=approximately25mLfrom SensaT.R.A.C.™Padtocanister. Protect Periwound Skin:Consideruseofaskinpreparationproducttoprotectperiwoundskin. Donotallowfoamtooverlapontointactskin.Protectfragile/friableperiwoundskinwithadditional drape,hydrocolloidorothertransparentfilm. Keep Negative Pressure On:Neverleavethedressinginplacewithoutactivenegativepressure formorethantwohours.Ifnegativepressureisoffformorethantwohours,changedressingas showninthedressingapplicationinstructions.Eitherapplyanewdressingfromanunopened sterilepackageandrestartnegativepressure,orapplyanalternativedressing. TheVisceralProtectiveLayerisfenestratedtoallowforactivefluidremovalwhennegativepressure isappliedandisdesignedtoallowapplicationofthislayerdirectlyoveromentumorexposed internalorgans. Monitor Fluid Output:Thedressingisdesignedtoefficientlyremovefluidfromtheabdominal compartmentandtoevenlydistributenegativepressure.WhentreatingpatientswithNegative PressureTherapy,thevolumeofexudateinthecanisterandtubingshouldbefrequentlyexamined. Adhesions and Fistula Development:Formationofadhesionsofthevisceratotheabdominal wallmayreducethelikelihoodoffascialreapproximationandincreasetheriskoffistula developmentwhichisacommoncomplicationinpatientswithexposedviscera. • Instillationofunwarmedfluidinlargequantitiesmayleadtohypothermia. • Suturingand/oranastomoses Intra-abdominal Packing:Whenusingintra-abdominalpackingwithNegativePressureTherapy, packingmaterialmaybedrierthananticipated.Evaluatepackingmaterialpriortoremovaland rehydrateifnecessarytopreventadherenceordamagetoadjacentstructures. Bradycardia:Tominimizetheriskofbradycardia,thedressingmustnotbeplacedinproximityto thevagusnerve. Only Use the SensaT.R.A.C.™ Pad:Substitutionwithanyothertubing,alterationofthe SensaT.R.A.C.™PadorbreachoftheprescribedSensaT.R.A.C.™Padapplicationforthepurposeof instillingfluidsintotheopenabdomenisnotrecommendedunderanycircumstance.Thismay leadtolossofsystemefficacyorharmtothepatient. Thefollowingconditionsmayincreasetheriskofpotentiallyfatalbleeding. VISCERAL PROTECTIVE LAyER APPLICATION Standard Precautions:Toreducetheriskoftransmissionofbloodbornepathogens,apply standardprecautionsforinfectioncontrolwithallpatients,perinstitutionalprotocol,regardless oftheirdiagnosisorpresumedinfectionstatus.Inadditiontogloves,usegownandgogglesif exposuretobodyfluidsislikely. Use of Visceral Protective Layer:WhenusingNegativePressureTherapy,ensurethattheVisceral ProtectiveLayercompletelycoversallexposedvisceraandcompletelyseparatestheviscerafrom contactwiththeabdominalwall.PlacetheVisceralProtectiveLayerovertheomentumorexposed internalorgans,andcarefullytuckitbetweentheabdominalwallandinternalorgans,makingsure theVisceralProtectiveLayercompletelyseparatestheabdominalwallfromtheinternalorgans. Magnetic Resonance Imaging (MRI) – Therapy Unit:TheNegativePressureTherapyUnitisMR unsafe.DonottakethedeviceintotheMRenvironment. Hemostasis must be achieved prior to dressing placement. PRECAUTIONS • Inadequatewoundhemostasis Drape(4) WOUND PREPARATION WARNING: Review all ABThera™ SensaT.R.A.C.™ Open Abdomen Dressing Safety Information before beginning wound preparation. Ensure adequate hemostasis has been achieved prior to dressing placement (refer to Bleeding section under WARNINGS). 1. Sharpedgesorbonefragmentsmustbeeliminatedfromwoundareaorcovered(referto BleedingsectionunderWARNINGS). 2. Irrigateabdominalwoundandcleanseperiwoundskinasindicated. 3. Cleananddryperiwoundtissue;consideruseofaskinpreparationproducttoprotect periwoundskin.Donotallowfoamtooverlapontointactskin.Protectfragile/friable periwoundskinwithadditionaldrape,hydrocolloidorothertransparentfilm. Fig. 5 A B C 1. CutVisceralProtectiveLayerawayfromwound,throughcenteroflargefoamsquaresusing sterilescissors(Fig 5A).Donotcutthroughnarrowconnectingtabsbetweenthelargefoam squares. 2. Pinchtheremaininghalfofthefoamsquareanditsconnectingtabandpull.Thefoamandtab willseparateatthenextsquare(Fig. 5B).ThiswillensurethatedgesofVisceralProtectiveLayer coverexposedfoamedge(Fig. 5C)andfoamcannotcontactorgans(seeWARNINGabove). 3. Documentnumberoffoamextensionsremovedandthateachpiecehasbeenproperly disposedofawayfromwoundcavity. CAUTION: Do not tear the foam over the wound, as fragments may fall into the wound. Rub or trim foam away from wound, removing any fragments to ensure loose particles will not fall into or be left in the wound upon dressing removal. PERFORATED FOAM APPLICATION SENSAT.R.A.C.™ PAD APPLICATION Fig. 16 1 1 1 4. Initiatetherapy.Assessdressingtoensureintegrityofseal.Thedressingshouldcollapseand haveawrinkledappearance.Thereshouldbenohissingsounds.Ifthereisanyevidenceofnonintegrity,checkdrapeandSensaT.R.A.C.™Padseals,tubingconnections,andcanisterinsertion, andensureclampsareopen.Secureexcesstubingtopreventinadvertenttensionontubing, whichmaydisrupttheseal. 1 1 1 2 2 2 2 1 Fig. 6 Fig. 7 Fig. 8 Fig. 14 Bleeding: Patients with abdominal wounds must be closely monitored for bleeding as these wounds may contain hidden blood vessels which may not be readily apparent. If sudden or increased bleeding is observed in the dressing, tubing or canister, immediately discontinue Negative Pressure Therapy, take appropriate measures to stop bleeding, and contact the physician. Negative Pressure Therapy is not designed to prevent, minimize or stop bleeding. (Refer to WARNINGS, Bleeding section). Fig. 15 Fig. 17 Theperforatedfoam(Fig. 6)providedwiththeABThera™SensaT.R.A.C.™OpenAbdomenDressing isintendedto: Monitor Fluid Output - Thedressingisdesignedtoefficientlyremovefluidfromtheabdominal compartmentandtoevenlydistributenegativepressure.WhentreatingpatientswiththeNegative PressureTherapyUnit,thevolumeofexudateinthecanisterandtubingshouldbefrequently examined • TransfernegativepressurefromtheNegativePressureTherapyUnittotheVisceralProtective Layertopromoteactivefluidremoval. • Providemedialtensionuponfoamcollapsetohelpmaintainfascialdomain. 1. Tearorcutperforatedfoamtoneededsizeasshownbelow(Fig. 7).Thefoamshouldfit directlyovertheVisceralProtectiveLayerandbeincontactwithwoundedges.Donotallow foamtocontactintactskin.Oneorbothpiecesoftheprovidedperforatedfoamcanbeused, dependingonthewoundprofile. 2. GentlyplaceperforatedfoamintowoundcavityovertheVisceralProtectiveLayer(Fig. 8). Ensurethatperforatedfoamdoesnotgobelowtheleveloftheabdominalincisionorwound. Donotforcefoamintoanyareaofthewound. ALARM RESOLUTIONS Alltherapyunitalarmsshouldbeaddressedinatimelymanner.Refertothetherapyunituser manualforcompleteinformationonalarmresolutions. NOTE: Do not cut off the pad or insert the tubing into the foam dressing. This may occlude the tubing and cause the Negative Pressure Therapy Unit to alarm and could injure underlying viscera. NOTE: Ensure foam-to-foam contact for even distribution of negative pressure. 1. Choosepadapplicationsite.Giveparticularconsiderationtofluidflowandtubingpositionto allowforoptimalflowandavoidplacementoverbonyprotuberancesorwithincreasesinthe tissue. NOTE: Always note the total number of pieces of foam used and document on the drape and in the patient’s chart. 2. Pinchdrapeandcuta2.5 cmhole(notaslit)throughthedrape(Fig. 14).Itisnotnecessaryto cutintothefoam. NOTE: Cut a hole rather than a slit, as a slit may self-seal during therapy. DRAPE APPLICATION Fig. 9 Fig. 10 3. Applypad,whichhasacentraldiscandasurroundingouteradhesiveskirt. Fig. 11 • Gentlyremovebothbackinglayers1and2toexposeadhesive(Fig. 15). • Placepadopeningincentraldiscdirectlyoverholeindrape(Fig.16). Incaseofaleakalarm,patchleaksourcewithadditionaldrapetoensureintegrityofseal. CAUTION: Due to the highly exudative nature of abdominal wounds, Negative Pressure Therapy should be interrupted only for wound care and dressing change. Interruption of therapy can result in loss of seal integrity. DRESSING CHANGES Dressingchangesshouldoccurevery24to72hours,ormorefrequentlybaseduponacontinuing evaluationofwoundconditionandpatientpresentation.Considermorefrequentdressingchanges inthepresenceofinfectionorabdominalcontamination. Wheneverthedressingischanged,alwaysreplacealldressingcomponentswithcomponentsfrom anunopenedsterilepackage. 2 • Applygentlepressureonthecentraldiscandouterskirttoensurecompleteadhesionof 1 2 1 2 1 1 2 DRESSING REMOVAL 1 2 1 1 4. Pullbackonbluetabtoremovepadstabilizationlayer(Fig. 17).Dressingapplicationis complete. 2 1 1 2 1 2 2 1 2 1 2 V.A.C.® NEGATIVE PRESSURE THERAPy APPLICATION Fig. 12 KaplanM.Managingtheopenabdomen.OstomyWoundManagement,2004Jan;50(1Asuppl);C2, 1-8 KaplanM,BanwellP,OrgillDP,IvaturyRR,DemetriadesD,MooreFA,MillerP,NicholasJ,HenryS, GuidelinesfortheManagementoftheOpenAbdomen.WOUNDS.2005Oct;17(Suppl1);S1S24 GarnerGB,WareDN,CocanourCS,DukeJH,McKinleyBA,KozarRA,MooreFA.Vacuum-assisted woundclosureprovidesearlyfascialreapproximationintraumapatientswithopenabdomens.The AmericanJournalofSurgery,2001Dec;182(6);630-8 BarkerDE,KaufmanHJ;VacuumPackTechniqueofTemporaryAbdominalClosure;A7-Year Experiencewith112Patients.Presentedatthe59thAnnualMeetingoftheAmericanAssociationfor theSurgeryofTrauma.September16-18,1999.BostonMass. BrockWB,BarkerDE;TemporaryClosureofOpenAbdominalWounds;TheVacuumPack.Presented atthe66thAnnualScientificMeetingoftheSoutheasternCongress,LakeBuenaVista,Florida. February6-10,1994 SherckJ,SeiverA;Coveringthe“OpenAbdomen”;ABetterTechnique.PresentedasaPosterat the66thAnnualScientificMeetingandthePostgraduateCourseProgram.SoutheasternSurgical Congress.Atlanta,Georgia.January31-February4,1998. CONTACT INFORMATION Forquestionsregardingthisproduct,maintenance,oradditionalinformationaboutKCIproducts andservices,pleasecontactKCIoraKCIauthorizedrepresentative,or: IntheUScall1-800-275-4524orvisitwww.kci1.comorwww.openabdomen.com. OutsidetheUSvisitwww.kci-medical.com. MANUFACTURER INFORMATION RefertoApplication SettingsectionunderWARNINGS. thepad. REFERENCE LIST Referencesavailableonrequest.PleasecontactKCIat1-800-275-4524(intheUS). Remove and discard previous dressing per institution protocol. Completely inspect wound, includingparacolicgutters,toensureallpiecesofdressingcomponentshavebeenremoved. Ifintra-abdominalpackingispresent,packingmaterialmaybedrierthananticipated.Evaluate packingmaterialpriortoremovalandrehydrateifnecessarytopreventadherenceordamageto adjacentstructures. 0473 KCI USA, Inc. San Antonio, TX 78219 USA 1-800-275-4524 www.kci1.com EC REP KCI Medical Products (UK), Ltd. Wimborne, Dorset BH21 7SH United Kingdom www.kci-medical.com WARNING: Refer to Dressing Removal section under WARNINGS. EXPLANATION OF SyMBOLS USED Donotuseifpackageis damagedoropen Fig. 13 Fig. 18 Manufacturer Singleuseonly DateofManufacture 1. Holdingthedrape,partiallypullbackonesideoflayer1toexposeadhesive(Fig. 9).Besureto holdlayer1flapback,topreventre-adherencetodrape. NOTE: Only for use with Negative Pressure Therapy provided by InfoV.A.C.®, V.A.C.® ATS and V.A.C.Ulta™ Negative Pressure Therapy Units. Refer to the therapy unit user manual for complete instructions for use. 2. Placethedrapeadhesive-sidedowntocoverfoamandintactskin,ensuringdrapecoversat leastan8-10cmborderofintactperiwoundtissue(Fig. 10).Useanyexcessdrapetoseal difficultareas,ifneeded. NOTE: SensaT.R.A.C.™ Pad tubing is not compatible with hospital vacuum systems. NOTE: To avoid trauma to the periwound skin, do not pull or stretch the drape over the foam dressing. Minimize wrinkles, as they may be a source of negative pressure leaks (refer to PRECAUTIONS, Protect Periwound Skin section). 3. Removeremainingtab1backingmaterialandpatarounddrapetoensureanocclusiveseal. WARNING: Review all Negative Pressure Therapy System Safety Information before initiating therapy. 1. Removecanisterfrompackagingandinsertintothetherapyunituntilitlocksintoplace. n 4. Removegreen-stripedstabilizationlayer2(Fig. 11). 5. Removeperforatedbluehandlingtabsfromdrape(Fig. 12). NOTE: If the canister is not fully engaged, the therapy unit will alarm. ContainsPhthalates AuthorizedRepresentativein theEuropeanCommunity Methodofsterilization- Radiation Useby 2. ConnectSensaT.R.A.C.™Padtubingtocanistertubingandensureclamponeachtubeisopen (Fig. 18).Positionclampsawayfrompatient. 3. Turnonpowertothetherapyunitandselect125mmHg,continuousmodetherapysetting forefficientfluidremovalrates.Negativepressuretherapysettingsbelow125mmHgarenot recommended. Contentinformation Each NOTE: Abdominal wounds often have copious drainage. Consider using the 1000 cc / mL canister. Ensure an adequate supply of canisters is readily available. CAUTION: Consider the size and the weight of the patient, patient condition, wound type, monitoring capability and care setting when using the 1000 cc / ml canister. NOTE: When using multiple pieces of drape, ensure that the edges of the drape overlap in order to achieve a seal (Fig. 13). Consultinstructionsforuse ConformswiththeMedicalDevice Directive(93/42/EEC)andhasbeen subjecttotheconformityprocedures laiddowninthecouncildirective. CAUTION:Federal(US)lawrestricts Keepdry thisdevicetosale/rentalbyoron theorderofaphysician. CAUTION: Do not use intermittent therapy / Dynamic Pressure Control (DPC) with the ABThera™ SensaT.R.A.C.™ Open Abdomen Dressing. AlltrademarksdesignatedhereinarepropertyofKCILicensing,Inc.,itsaffiliates,and/orlicensors. ©2013KCILicensing,Inc.AllRightsReserved.370553RevD1/2013