Hey Lauren! Thanks for your question. I typically will cut the foam larger at the wound opening and purposefully fit a much larger amount of foam than normal. This can be uncomfortable but it will help with preventing premature closure of the opening before the internal cavity.

Great tips Samantha! Nataliya Lebedinskaya RN, BSN, CWOCN also chimed in, below are her suggestions:

"Basically, we should not let the wound opening close faster than the cavity. I use silver nitrate on the edges to prevent that. Proper packing is important and very helpful (as described by Samantha). But in cases in which I see the patient and the opening is already too small relative to the size of the cavity, I would stop VAC and pack, if no improvement in the size of cavity within 3 weeks, surgical intervention"