NPWT Companies

Issue Number: 
Volume 5 Issue 5 - June/July 2011

Kinetic Concepts, Inc. (KCI)

San Antonio, Texas
Founded: 1976
www.KCI1.com
media@kci1.com
(800) 275-4524

1) How many different NPWT products does your company currently produce?
KCI manufactures and sells five different NPWT products: ActiV.A.C.® Therapy System, InfoV.A.C.® Therapy System, V.A.C. Instill® Wound Therapy, V.A.C. Freedom® Therapy System and, most recently, the V.A.C.Via™ Therapy System. The V.A.C.Via™ Therapy System is KCI’s first for-sale, single-use NPWT unit. V.A.C.® Therapy is the leading NPWT brand and the most studied among NPWT products. Other KCI devices within its Negative Pressure Technology (“NPT”) portfolio include the Prevena™ Incision Management System and the ABThera™ Open Abdomen Negative Pressure Therapy System. For a list of published clinical evidence for our products, go to http://www.kci1.com/KCI1/clinicalevidence.

2) Please name your most popular NPWT product?
The ActiV.A.C® Therapy System is currently our most popular NPWT product.

3) What is the suction pressure of your machine or the range of pressure that the machine achieves?
The pressure provided by the ActiV.A.C.® Therapy System is preset to -125 mmHg. This default setting is within the V.A.C.® Therapy Clinical Guidelines recommended range for most wounds. The user selectable negative pressure range is between 25-200 mmHG, with the pressure setting selection being left to physician discretion.

4) Is the pressure pre-set?
The pressure provided by the ActiV.A.C® Therapy System is preset to -125 mmHg and continuous therapy.

5) Can it be changed?
Yes, the level of therapeutic negative pressure for all KCI NPWT units can be changed by using the control panel on the therapy unit. Settings are adjustable based on individual patient clinical needs and circumstances.

6) Is there an intermittent feature?
Yes, all KCI NPWT units, including the ActiV.A.C.® Therapy System, offer both continuous and intermittent negative pressure therapy applications.

7) Is there a cut off which stops suction if the canister is full?
All of our NPWT units contain electronic sensors that stop the pump when the canister is full.

8) Is there a one-way valve to prevent fluid from coming back through the tubing towards the patient?
No, there are no one-way valves in the system; however, there are other safety features, which mitigate retrograde flow toward the patient. KCI’s proprietary SensaT.R.A.C.™ Tubing used in conjunction with V.A.C.® Therapy has clamps at both the patient and canister side to prevent this fluid transfer. Additionally, canisters are available with a gel pack that helps to solidify wound exudate.

9) How long does the battery last?
The ActiV.A.C.® Therapy System’s battery lasts for 14 hours on average when fully charged.

10) How much does the machine weigh?
The ActiV.A.C.® Therapy System is fully portable and only weighs 2.4 lbs. when the 300ml canister is empty. The recently launched V.A.C.Via™ Therapy System is specifically designed for mobility and weighs only 0.7 lbs with a 250ml canister.

11) What is the interface with the wound?
KCI offers a variety of wound dressings:
•V.A.C.® GranuFoam™ Dressing
•V.A.C. GranuFoam Silver® Dressing
•V.A.C.® WhiteFoam Dressing
•V.A.C.® Simplace™ Dressing
•V.A.C.® GranuFoam™ Bridge Dressing
Additional V.A.C.® GranuFoam™ specialty dressings are available.
The V.A.C.® GranuFoam™ Dressing is placed directly at the wound site to facilitate negative pressure application. The unique pore structure of V.A.C.® GranuFoam™ Dressings help promote healing and tissue granulation. Each tiny pore is intended to deliver mechanisms critical to wound healing. The V.A.C.® GranuFoam™ Dressing adapts to the contours of deep and irregularly shaped wounds, helps provide uniform distribution of negative pressure at the wound site, helps facilitate exudate and infectious material removal through a hydrophobic pore structure, compresses to less than half its size under negative pressure to help draw wound edges together and induces macrostrain and microstrain.

12) How often do you recommend changing the dressing?
Current device labeling recommends that following: Wounds being treated with V.A.C.® Therapy should be monitored on a regular basis. In a monitored, non-infected wound, V.A.C.® Dressings should be changed every 48 to 72 hours, but no less than three times per week, with frequency adjusted by the clinician as appropriate.
Infected wounds must be monitored often and very closely. For these wounds, the dressing change intervals should be based on a continuing evaluation of wound condition and the patient’s clinical presentation, rather than a fixed schedule. Dressings may need to be changed more often than 48 to72 hours.

13) Can you “y” wounds together and if so how many?
Yes, the ActiV.A.C.® Therapy System can be used to “Y” two wounds together if they are of the same etiology. By applying a Y-connector to the canister tubing, one V.A.C.® Therapy unit may be used to simultaneously treat multiple wounds on the same patient.

14) How do you handle undermining?
KCI V.A.C.® Therapy WhiteFoam Dressing may be placed in undermined areas, with good foam to tissue contact. When using the V.A.C.® Therapy WhiteFoam Dressing, the minimum pressure setting is -125 mmHg.

15) How often do you handle fistulas?
V.A.C.® Therapy is contraindicated for use with non-enteric and unexplored fistulas. If considering the use of V.A.C.® Therapy involving enteric fistula, it’s recommended to seek support from an expert clinician. V.A.C.® Therapy is not recommended or designed for fistula effluent management or containment, but as an aid to wound healing in and around the fistula.

16) How do you handle exposed tendon or bone?
Tendons, ligaments and nerves should be protected to avoid direct contact with V.A.C.® Dressings, and can be covered with natural tissue or meshed non-adherent porous material or bioengineered tissue to help minimize risk of desiccation or injury. Bone may be protected with a single layer of a non-adherent interface.

17) Do you have any special recommendations for high bioburden or infection?
V.A.C.® Therapy is contraindicated for untreated osteomyelitis. If a clinician decides to use V.A.C.® Therapy for other infected wounds, then they must be monitored often and very closely, and dressings may need to be changed more often than 48 to 72 hours in order to assess the wound and patient condition. The dressing change intervals should be based on a continuing evaluation of wound condition and the patient’s clinical presentation, rather than a fixed schedule.

18) How is your device billed? (Is the machine rented and how are supplies obtained?)
The ActiV.A.C.® Therapy System and V.A.C. Freedom® Therapy Systems, are rented and typically billed to the patient’s insurance depending on eligibility and coverage. Dressings are available for purchase, and supplies are replenished, as needed, based on clinical evaluation by healthcare professionals.
For proper use of KCI NPWT products, please refer to the V.A.C.® Therapy Clinical Guidelines, A Reference Source for Clinicians, and device labeling.

Kalypto Medical

Mendota Heights, MN
Founded: 2006
www.WoundExpert.com
info@kalyptomedical.com
(651) 289-0284 or (877) 286-3740

1) How many different NPWT products does your company currently produce?
6 (1 pump and 5 dressings)

2) Please name your most popular product.
NPD 1000
NPWT Pump and 25cc wound kit.

3) What is the suction pressure of your machine or the range of pressure that the machine achieves?
40 – 125mmHg.

4) Is the pressure pre-set?
Automatically goes to 125mmHg when turned on for the first time.

5) Can it be changed?
Yes

6) Is there an intermittent feature?
Yes

7) Is there a cut off which stops suction if the canister is full?
There is no canister

8) Is there a one-way value to prevent fluid from coming back through the tubing towards the patient?
Exudate is trapped within the dressing and never enters the tube.

9) How long does the battery last?
3 alkaline AA batteries last for approximately 3 weeks

10) How much does the machine weight? (How portable is it?)
8 oz.

11) What is the interface with the wound?
Silverlon® wound contact area (minimally adherent antimicrobial barrier)

12) How often do you recommend changing the dressing?
2-3 times per week.

13) Can you “y” wounds together and if so how many?
Yes you can treat 2 wounds simultaneously.

14) How do you handle undermining?
At the discretion of the care/clinical provider.

15) How often do you handle fistulas?
We are contraindicated for unexplored and non-enteric fistulas.

16) How do you handle exposed tendon or bone?
Always ensure NPWT doesn’t come in direct contact; they should be protected.

17) Do you have any special recommendations for high bioburden or infection?
Patients with infection may be at an increased risk of bleeding from NPWT and therefore should be treated and monitored in a care setting deemed appropriate by the treating physician.

18) How is your device billed? (Is the machine rented and how are supplied obtained?)
The device is rented on a monthly or daily basis from local HME dealers and the wound kits are purchased based on medical necessity.

ATMOS Inc.

Allentown, PA
Founded: in Germany in 1904
www.atmos-npwt.com
jjones@atmosmed.com
(866) 862-8667

1) How many different NPWT products does your company currently produce?
We produce one portable system called the ATMOS S041 Wound, and a variety of dressing kits and accessories.

2) Please name your most popular NPWT product?
ATMOS S041 NPWT System.

3) What is the suction pressure of your machine or the range of pressure that the machine achieves?
We recommend using -80 mmHg for most wounds, however the ATMOS S041 Wound is adjustable in increments of 1mmHg within the range of -10mmHg to -200mmHg.

4) Is the pressure pre-set?
When the ATMOS S041 Wound is activated, the pressure level resets to the level of the previous therapy session.

5) Can it be changed?
Yes, the ATMOS S041 Wound is adjustable in increments of 1mmHg with in the range of -10mmHg to -200mmHg.

6) Is there an intermittent feature?
Yes, the ATMOS S041 Wound features a fully programmable intermittent therapy mode.

7) Is there a cut off which stops suction if the canister is full?
Yes, our canister system includes an integrated suction-block when the canister is filled.

8) Is there a one-way value to prevent fluid from coming back through the tubing towards the patient?
Our tubing is single lumen, and comes with a clamp to block-off the tube with suction is not active.

9) How long does the battery last?
24 hours on a fully charged battery.

10) How much does the machine weight? (How portable is it?)
The system weighs less than 5lbs

11) What is the interface with the wound?
ATMOS offers a variety of Sterile Gauze-based Dressing kits, featuring Kerlix AMD.

12) How often do you recommend changing the dressing?
Every 48-72 hours depending on the clinician’s discretion.

13) Can you “y” wounds together and if so how many?
The ATMOS S041 Wound allows you to “Y” together up to 8 wounds on a single patient.

14) How do you handle undermining?
Our clinical protocols recommend curling a gauze-wrapped round drain into the undermined areas.

15) How often do you handle fistulas?
Explored fistulas may be treated with using a slightly modified dressing kit process. Our XL kit may be necessary to handle large amounts of exudate.

16) How do you handle tendon and bone?
A non-adherent dressing layer is included in every dressing kit. This layer should be applied to the wound before the guaze is placed.

17) Do you have any special recommendations for high bioburden or infection?
Our clinical protocols recommend changing the dressing kit more often for highly infected wounds. The addition of silver-based products has been used in conjunction with our NPWT System.

18) How is your device billed? (Is the machine rented and how are supplied obtained?)
The ATMOS S041 Wound is available for rental or purchase through our nationwide DME network. Additionally, long-term care facilities can now purchase the ATMOS S041 Wound though our partnership with DirectSupply.

Innovative Therapies, Inc.

Gaithersburg, MD
Founded: 2006
www.itimedical.com
CustomerService@itimedical.com
(866) ITI-NPWT (484-6798)

1) How many different NPWT products does your company currently produce?
We have 2 NPWT units – SVED and Svedman Wound Treatment Systems, black and white foam dressings, and accessories.

2) Please name your most popular NPWT product?
NPWT Units:SVED and Svedman Wound Treatment Systems

3) What is the suction pressure of your machine or the range of pressures that the machine achieves?
Our one-touch NPWT therapy unit is designed to provide three pressure choices: -70 mmHg, -120 mmHg, and -150 mmHg.

4) Is the pressure pre-set?
The default pressure setting is -120 mmHg

5) Can it be changed?
Yes, it can be changed with the touch of a button. ITI is the first company to introduce a “One Touch” operation of its NPWT units.

6) Is there an intermittent feature?
Yes. The SVED/Svedman NPWT units’ intermittent feature is 5 min ON at set pressure, 2 min OFF at -25mmHg. The rationale for not going all the way to zero is to prevent the dressing from becoming dislodged and leaking when the seal is lost during the off cycle.

7) Is there a cut off which stops suction if the canister is full?
Yes, the canister has a device to prevent fluid egress when the canister is full.

8) Is there a one-way valve to prevent fluid from coming back through the tubing towards the patient?
The canister acts as a fluid trap. Once fluid enters, it is prevented from leaving the canister. In addition a gelling agent is used to convert the fluid to a semi-solid state and help prevent inadvertent spills.

9) How long does the battery last?
Up to 18 hours, but this depends on the pressure setting and the dressing seal.

10) How much does the machine weigh? (How portable is it?)
The SVED weighs less than two pounds. It comes with a shoulder bag for portability. The larger Svedman weighs less than 5.5 pounds

11) What is the interface with the wound?
Two types of foam choices are used as wound interfaces: a black hydrophobic foam, and a white hydrophilic foam.

12) How often do you recommend changing the dressing?
Routine dressing changes should occur every 48 to 72 hours. Dressing changes for infected wounds should be done more frequently than 48-72 hours.

13) Can you "y" wounds together and if so how many?
You can Y multiple wounds together. Use of the “Y” connector must be determined on a case-by-case basis and is dependent on size and depth of the multiple wound sites. Multiple wounds may be connected together with a foam bridge. Multiple therapy units can be used with a patient as well.

14) How do you handle undermining?
Because of the high tensile strength of the ITI black foam, undermining may be filled in with black foam. For deeper undermining, we suggest that the clinician wrap the black foam with a wound contact layer to prevent it from sticking inside the undermining.

15) How do you handle fistulas?
ITI suggests the clinician consider using irrigation to keep the effluent thin so that foam does not become occluded. Also, if appropriate, the pressure may be increased to -150 mmHg.

16) How do you handle exposed tendon or bone?
ITI recommends that these structures be covered with our white foam to encourage granulation.

17) Do you have any special recommendations for high bioburden or infection?
The ITI irrigation feature provides continuous or intermittent irrigation in conjunction with continuous negative pressure suction. Any irrigation solution indicated for topical wound treatment may be used, including antimicrobials and antibiofilm agents. In addition, a silver wound contact layer may be used underneath the foam if a topical antimicrobial is desired.

18) How is your device billed? (Is the machine rented and how are supplies obtained?)
The device may be rented, and the disposables are purchased. The SVED and Svedman Wound Treatment Systems are reimbursed under Medicare code E2402.

Medela, Inc.



McHenry, IL


Founded: 1961
www.medela.com
suction@medela.com
(877) 694-6842

1) How many different NPWT products does your company currently produce?
Complete NPWT Portfolio – Pumps , Wound Care Kits, & Accessories



2) Please name your most popular NPWT product?
Invia Liberty



3) What is the suction pressure of your machine or the range of pressure that the machine achieves?
60mmHg – 200mmHg



4) Is the pressure pre-set?
Yes

5) Can it be changed?
Yes

6) Is there an intermittent feature?
Yes

7) Is there a cut off which stops suction if the canister is full?
Initial warning 30 minutes prior, with auto shutoff.



8) Is there a one-way value to prevent fluid from coming back through the tubing towards the patient?
Yes

9) How long does the battery last?
Up to 14 hours

10) How much does the machine weight? (How portable is it?)
2.2 pounds



11) What is the interface with the wound?
Wound contact layer, foam or gauze



12) How often do you recommend changing the dressing?
2-3 times weekly

13) Can you “y” wounds together and if so how many?
Yes, at least 4 or at clinician discretion
.
14) How do you handle undermining?
15F Channel drain specifically designed for this purpose

15) How often do you handle fistulas?
Enteric and explored fistula may be manage with the 15F Channel drain specifically designed for this purpose.

16) How do you handle exposed tendon or bone?
Yes, with precaution and covering all fragile structures with wound contact layer.

17) Do you have any special recommendations for high bioburden or infection?
Our customary kits contain anti microbial gauze specifically designed for this purpose.

18) How is your device billed?(Is the machine rented and how are supplied obtained?)
The devices may be obtained through rental or purchase. Both devices and kits are reimbursed through Medicare Part B and commercial payers.

Invacare Corporation



Elyria, OH

Founded: 1979
MoblVacNPWT.com
info_icc@invacare.com
(877) 789-1146

1) How many different NPWT products does your company currently produce?
Invacare offers the MoblVac® NPWT System and TruSeal™ Link wound care kits.

2) Please name your most popular NPWT product?
MoblVac® NPWT System.



3) What is the suction pressure of your machine or the range of pressure that the machine achieves?
0-200mm Hg.


4) Is the pressure pre-set?
The MoblVac® pre-set level is 25 mm Hg and allows adjustable pressure up to 200 mm Hg.

5) Can it be changed?
The MoblVac® allows adjustable pressure up to 200 mm Hg.

6) Is there an intermittent feature?
The MoblVac® provides both continuous and intermittent NPWT.

7) Is there a cut off which stops suction if the canister is full?
Yes.

8) Is there a one-way value to prevent fluid from coming back through the tubing towards the patient?
No. There is a clamp on the tubing that can help prevent fluid from returning to the patient.

9) How long does the battery last?
24 hours with a good seal.

10) How much does the machine weigh? (How portable is it?)
5.1 lbs. The MoblVac® is a portable unit that is commonly used with our discreet carrying bag.

11) What is the interface with the wound?
Antimicrobial Gauze.

12) How often do you recommend changing the dressing?
Up to 72 hours.

13) Can you “y” wounds together and if so how many?
Invacare provides instructions and Y-connectors for bridging of multiple wounds. There is no system limit to the number of wounds bridgeable.

14) How do you handle undermining?
The TruSeal™ Link wound care kits come in different sizes and configurations to accommodate different drainage requirements and wound types. Clinicians can select the appropriate dressing for the wound types and their facility needs with a variety of drain types, drain sizes and dressing sizes. All TruSeal™ Link wound care kits are complete and offer solutions for a variety of wounds.

15) How often do you handle fistulas?
The MoblVac® NPWT System can be used with EXPLORED enterocutaneous fistulas. Documentation from the FDA considers non-enteric or unexplored fistulas to be contraindicated for NPWT. Please see the clinical guidelines for additional information.

16) How do you handle exposed tendon or bone?
Based on the clinical guidelines, a contact dressing layer may be used to completely cover any exposed tendons, ligaments, blood vessels, organs, any exposed bowel, nerves, and suture lines. Completely cover and protect prior to application of NPWT. Please see the clinical guidelines for additional information..

17) Do you have an special recommendations for high bioburden or infection?
We recommend constantly monitoring patients for infection. If odor or clinical signs of infection are noted, contact the treating clinician immediately. Please see the clinical guidelines for additional information.

18) How is your device billed? (Is the machine rented and how are supplied obtained?)
The MoblVac® NPWT System is available for rental, and supplies available for purchase, through a national network of Invacare Rentals locations that are supported by a staff of field-based Clinical Specialists.

Smith & Nephew



St. Petersburg, FL


Founded: 1856
www.myrenasys.com
www.smith-nephew.com
(800) 876-1261

1) How many different NPWT products does your company currently produce?
Over 25 products including RENASYS™ GO and RENASYS-EZ PLUS pumps, RENASYS-F/P Foam and RENASYS-G/P Gauze based dressing kits with ports, RENASYS-F/AB Abdominal Dressing Kit, RENASYS high output fistula kit, RENASYS Channel drain kit, 800ml, 250ml and 300 ml canisters, transparent films, Y-Connectors and other NPWT accessories 


2) Please name your most popular NPWT product?
The RENASYS GO pump is our most popular NPWT product. It is an effective and user-friendly device. The pump is lightweight (2.4 lbs.), quiet and can be used with either a 300ml or 800ml canister, which enhances flexibility for home care, or acute care use.



3) What is the suction pressure of your machine or the range of pressure that the machine achieves?
• RENASYS GO (40mmHg – 200mmHg)
• RENASYS EZ PLUS (40mmHg – 200mmHg)



4) Is the pressure pre-set? The pressure will start with the last pressure setting when the pump was turned off or put on standby.

5) Can it be changed?
Yes

6) Is there an intermittent feature?
Yes

7) Is there a cut off which stops suction if the canister is full?
The pump is not turned off. The pump is protected if the canister is full by the filter. An audible alarm will sound and a visual light will flash if the canister is full.

8) Is there a one-way value to prevent fluid from coming back through the tubing towards the patient?
No

9) How long does the battery last?
• RENASYS GO (20 hours)
• RENASYS EZ PLUS (40 hours)

10) How much does the machine weight? (How portable is it?)
RENASYS GO (2.4 lbs.) Comes with shoulder strap and carry bag; RENASYS EZ PLUS (7.4 lbs.) Built in IV pole and bed rail attachments.

11) What is the interface with the wound?
(Foam or AMD Gauze)

12) How often do you recommend changing the dressing?
(Foam every 48 hrs.; AMD guaze 48-72 hrs.).

13) Can you “y-connect” wounds together and if so how many?
Yes, we recommend two wounds max)

14) How do you handle undermining?
Both RENASYS Foam and Gauze kits are indicated for undermining. We also recommend use of the Channel drain kit with moistened AMD Gauze or the RENASYS G/P kit for its conformability to these type wounds.

15) How do you handle fistulas?
We currently offer the high output fistula kit that includes a large 28fr round irrigation aspiration drain. This kit is indicated for explored fistulas.

16) How do you handle tendon and bone?
We offer in our gauze kits a non-adherent gauze and recommend the use of a non-adherent gauze layer for use with the foam interface to protect exposed tendon or bone while under NPWT.

17) Do you have any special recommendations for high bioburden or infection?
We recommend the use of Smith & Nephew ACTICOAT™ FLEX as a wound contact layer for wounds with high bio burden or infection. ACTICOAT FLEX is compatible for use with NPWT with gauze or foam interface materials.

18) How is your device billed? (Is the machine rented and how are supplied obtained?)
Our pumps are rented and dressing kits, canisters and other services supplied through our channel partners Universal Hospital Services (UHS) that support Acute Care & Long Term Care and Apria Healthcare that supports Home Care. Our channel partners perform third party billing and all BIOMED operations on the pumps to ensure quality pumps are delivered.

Prospera


Fort Worth, Texas


Founded: 2006
www.prospera-npwt.com
(888) 408-6798 (NPWT)

1) How many different NPWT products does your company currently produce?
We have two pumps ( PRO-II, & PRO-III). Disposable items include wound kits, canisters, filters, tubing, and carrying bags. There are pump attachments to secure the units to the footboard and/or IV pole. Replacement batteries and DC charger/adapters for the pumps, and wound kit parts available.

2) Please name your most popular NPWT product?
Our negative pressure pumps and our dressing kit with the 10mm flat perforated drain.


3) What is the suction pressure of your machine or the range of pressure that the machine achieves?
-10 mmHg to -200 mmHg in increments of 5 mmHg.



4) Is the pressure pre-set?
Yes. The pumps are pre-set at Continuous -80mmHg..

5) Can it be changed?
Yes

6) Is there an intermittent feature?
The pump features a modified intermittent called Variable Pressure Therapy or VPT in which the therapy is cycled between two lower pressure settings created a massage form of NPWT instead of off-on intermittent.

7) Is there a cut off which stops suction if the canister is full?
Yes

8) Is there a one-way value to prevent fluid from coming back through the tubing towards the patient?
The drains and tubing do not have an internal one-way valve. This would prevent the ability to irrigate. If needed, there are clamps on the tubing to prevent backflow. If NWPT was interrupted and back flow occurs, the microbes can be controlled by the anti-microbial impregnated hydrophilic gauze dressing.

9) How long does the battery last?
Battery life for the PRO-II and PRO-III: 24 to 36 months. Single charge usage is approximately 48 hours.

10) How much does the machine weight? (How portable is it?)
PRO-III 3.97 lbs. PRO-II 2.65 lbs. Each has a single use carrying bag.

11) What is the interface with the wound?
Polyhexamethylene Biguinide (PHMB) impregnated hydrophilic cotton gauze or reticulated open cell polyurethane foam.

12) How often do you recommend changing the dressing?
2-3 times a week

13) Can you “y” wounds together and if so how many?
Yes. 2 canisters can simultaneously be attached to the PRO-III. This allows for separation of exudate from multiple wound or fistula sites. Each canister can extend a Y connection to the drain tubing up to 4-8 tubings.

14) How do you handle undermining?
Undermining can be managed with either the 15 FR Round Channel drain or the loose packing of the AMD (anti-microbial dressing) gauze.

15) How often do you handle fistulas?
Prospera has a successful frequency with fistulas using the AMD gauze dressing. The 28 FR Wooding-Scott Lavacuator Drain and the 19 FR Round drain both manage fistula effluent without occluding the gauze wound filler interface. Foam based interface frequently occludes with heavy effluent.

16) Do you make custom solutions?
Mineral Oil or petrolatum non-adherent interface is used prior to the wound filler to promote moisture maintenance and adherence protection of the bone and tendon.

17) Do you have any special recommendations for high bioburden or infection?
Thorough cleansing of the wound surface area with each dressing change will promote reduction of the bio-burden. Contact of the AMD gauze containing PHMB will control microbes at the wound surface.

18) How is your device billed? (Is the machine rented and how are supplied obtained?)
The Prospera PRO-II and PRO-III are rented on a daily basis. Supplies can be ordered directly from the Fort Worth warehouse. Reimbursement codes for the NPWT unit, canister and dressing kit are the accepted NPWT codes of E2402, A7000, and A6550 respectively.