Learning how to do your own LVAD Dressing Changes

Living with a Left Ventricular Assist Device (LVAD) while you are still waiting for your heart transplant can be a whole different experience, especially when you are struggling to manage your device. Whether you have received LVAD as a bridge to transplant or as a permanent treatment, taking care of your LVAD is something you must learn, as it is absolutely essential. You may struggle at first, which is very normal, but with the right guidance and a bit of practice, you will be able to handle it like a pro.

One of the most important parts of your LVAD care is keeping your driveline clean and protected. Why is that? Because keeping it safe will eradicate the chances of various complications such as infection, irritation, or accidental pull on the driveline, and abscess. LVAD dressing change is part of the driveline care.

The good news is, once you understand the importance of doing it right and start following your doctor’s instructions exactly, changing an LVAD dressing will become a simple and regular process for you. Doing LVAD dressing changes will just become a part of your daily routine, and you may be able to do it without any mistakes. Here we have a step-by-step guide to help you do it right every single time.

Understand LVAD Components:

Before we jump into the step-by-step guide, let’s talk about what exactly you are working with. For that, you must know each component of your LVAD device to make sure that the site stays clean. Here is the LVAD device explained.

Your LVAD has both internal and external components. The internal part, the LVAD pump, is surgically placed in your heart, and the external components remain outside the body, which include batteries, the controller, and the driveline. The driveline is actually a thin cable that connects the LVAD pump inside your heart to the controller outside your body by exiting through your abdomen. This exit site is what you will be dressing and protecting.

Why the Driveline Dressing Matters?

The driveline exit site is a direct path into your body. That means if germs get in, they can travel straight to where your device is implanted and cause an infection. And believe me, that is not something you want to risk. It could lead to more serious problems with your heart. So, you need to cover this area by using sterile gauze and medical-grade dressings designed specifically to prevent infection.

Managing Controller and Batteries:

Even though managing these LVAD components is not part of the dressing change itself, it still requires attention to avoid complications. The controller manages the LVAD pump, which means we have to make sure that it does not pull or tug on the driveline.

To avoid such things, you need an LVAD shirt or LVAD belt and bags that are close to the body. These products are available in high-quality at LVADGear, with high durability and comfort. LVAD apparel helps prevent device shifting that can cause irritation and disturb you while you move.

The right gear can make a big difference in both your comfort and your confidence. By understanding how each part works together, you will be able to change dressing with a better peace of mind.

Things you need while doing your LVAD Dressing:

While every healthcare institute follows its unique protocols of LVAD dressing change, the ultimate goal is to reduce the chances of infection. Before starting, make sure you have everything arranged on a clean, dry surface:

Sterile dressing change kit
Antibacterial swabs or cleaning solution
Sterile gloves
Mask
Transparent dressing
Gauze and tape
Trash bag for disposal

Important Note: Before using any of the above material, always check expiration dates and sealed packaging. It is important to keep things germ-free.

Step-by-Step Guide for LVAD Dressing Change:

Changing LVAD dressing may seem quite a task for you at start, but once you get into it, it becomes a simple part of your routine. You will just take it as a regular task like brushing your teeth. Here is a complete guide, breaking down in steps, for you to understand how to do your own LVAD dressing changes:

Preparation for the procedure:

Wash your hands thoroughly with soap and warm water. Make sure the area is clean where you are going to perform the procedure. Sterilize the area completely and then put on a mask and gown yourself. Prepare the kit and lay out all your supplies on a clean towel or tray.

Remove the Old Dressing:

Put on clean gloves and gently peel away the old dressing. Be careful not to put excessive force or move the driveline too much. If you are using any device to protect the component, first remove it. Remove the old dressing by using adhesive remover. You can use any type of adhesive remover according to your facility. Apply first on the edges and then work your way around until the dressing is off.

Wash Your Hands Again:

After removing the dressing, toss your gloves and wash your hands once again, as it is necessary to perform the procedure in a sterilized environment.

Setting up the kit:

Open your sterile dressing kit or lay out your items carefully without touching them directly. Make sure that you are wearing your mask and hair cap. After that, put on sterile gloves by using the proper technique shown by your care team.

Clean the Exit Site:

Sanitize your hands first and inspect the driveline site properly. Check and report to your doctor if you notice any swelling, discharge, or allergy symptoms. By using an anti-bacterial solution, clean the area around the driveline in a circular motion, moving outward. Avoid going back toward the center. You can use any type of antibacterial provided by your doctor. Treat the driveline area for 60 to 100 seconds and then let it air dry. Do not dry the area by blowing air or using another dry cloth.

Apply the New Dressing:

Apply liquid adhesive away from the driveline insertion, where the edges of the gauze should be attached. Then cover with a transparent dressing to protect the site while keeping it visible. If you are using a securement device, apply it now to minimize movement.

Secure the Driveline:

Use medical tape or a driveline holder to protect and secure the driveline. This prevents tension and tugging at the exit site.

Clean Up:

Carefully remove and dispose of all used materials. Wash your hands again and disinfect the area by using alcohol pads or disinfectant.

Changing dressing is often done with showering with an LVAD, and you must schedule your LVAD dressing change after the shower, especially if the dressing gets wet.

Possible Complications of Changing LVAD Dressing and How to Avoid Them?

Even the task you do regularly holds some chances of error. So, even with regular practice, you've got to stay aware. Knowing what to watch for and how to prevent it can protect your health.

Exit Site Infection: If you notice any redness, swelling, fever, or pain at the driveline site, that could be a sign of infection. Infections often occur when properly sterilized techniques are not used.

How to avoid it: Always clean the site first and then properly apply antiseptics. Make sure to cover the area with sterilized gauze and perform dressing changes exactly on the scheduled days.

Bleeding: If you are using poor handling techniques and are not securing all the external components of the LVAD, you may cause bleeding or trauma to the skin.

How to avoid it: Be gentle when removing the old dressing without pulling or putting force on it. If you have sensitive skin, ask your doctor about skin barrier films for extra protection.

Allergic Reactions: If you see any rash, itching, or irritation at the driveline site, you might be reacting to dressing materials.

How to avoid it: Reach out to your doctor or team right away. They will recommend that you use dressing materials that are resistant to allergens.

Pulling the driveline: Accidentally pulling the driveline means you are putting force on the internal LVAD pump, definitely something to avoid.

How to avoid it: Before starting the dressing-changing procedure, make sure that the controller and batteries are secured in the LVAD apparel, like the LVAD vest. Stay still and avoid sudden movements while changing dressings.

Improper Dressing: Sometimes dressings become loose or too tight due to improper technique, which can cause irritation and infection.

How to avoid it: Follow each step carefully and make sure the edges of the dressings are well sealed. Do not use contaminated materials, as they raise the infection risk. Avoid touching the sterile side of the gauze and keep the area dry before applying it.

How I learned to change my LVAD Dressing:

I learned to do my own LVAD dressing changes. I had to do them daily. It gave my caregivers a break and allowed me to travel alone with my LVAD. Independence is a wonderful thing. There were many times that I made mistakes and started over, but it always got done.

Some Tricks for Learning LVAD Dressing Changes:

I stood in front of a big mirror in the bedroom or bathroom, and used the counter or dresser as my sterile area, after wiping it down clean. I got all of my materials out, then mentally double-checked everything before opening the first piece of gauze. Then I followed the routine the hospital taught me. Each hospital is slightly different, so I will leave the details out.

The LVAD shoulder bag and cotton twill LVAD Vest that we offer on the site were among the greatest improvements in my life. They completely ended my neck and back pain. You can view these items on the LVAD product pages.

I took a sharpie and made marks on my cords and battery connectors to line them up when switching from the night machine to batteries. I made it a game to switch without an alarm going off, because my wife was sleeping.

Final Thoughts:

Learning how to do your own LVAD dressing changes is a big step, but it inspires you to take control of your health and protect yourself from complications. By sticking to proper hygiene and following each step carefully, you are doing your part to keep the driveline site clean and infection-free. If you notice any changes or have any concerns, do not forget to consult with your doctor. It’s always better to ask than to risk it. Life after LVAD surely brings changes, but with little adjustments and thoughtful moves, you can enjoy a good quality of life while living with it.

FAQs

How often should I change my LVAD dressing?

LVAD dressing changes should be performed every day in the initial phase of recovery. But when the site is healed completely, you can change dressing once or twice weekly.