Dressing Change Instructions for the Continuous Flow Ventricular Assist Device (VAD)

Important information

It is important to keep the Ventricular Access Device (VAD) driveline site clean and dry.  To do this, the VAD dressing is changed using sterile technique. 

• If your child has a clear cover dressing with a window over the VAD site it is changed at least once a week, and more often if needed.

• If your child has a brown border cover dressing it is changed at least two times a week, and more often if needed.

• Dressing changes are always needed after your child showers, if the dressing becomes loose or soiled, and if the dressing is not intact.

Instructions for VAD dressing change

Gather supplies:

• VAD dressing change kit, which includes:

• Clean gloves to remove the dressing 

• Sterile gloves 

• Masks

• 2 cleaning wands 

• Saline wipe

• Silver plated dressing

• Skin prep wand

• Clear cover dressing to go over VAD site

• If your child uses a brown cover dressing, you will add this to the kit

• Additional dressings for reinforcement

• Securement device

1. Clean hands well with soap and water.

2. Clean work area with disinfectant and allow to dry.

3. Place VAD dressing change kit and extra cover dressing (if needed) onto clean work area.

4. Open dressing change kit, making sure there are no holes or rips in the kit. If there are holes or rips, throw the kit out and get a new one.

5. Place masks on caregiver and patient.

6. Clean hands well with soap and water. 

7. Put on clean gloves found in kit.

8. Remove the old dressing and assess for signs of infection, such as drainage, redness or swelling. If you see signs of infection, take a picture to send to the VAD team. Throw the old dressing away.

9. Remove gloves and clean hands.

10. If additional dressings or supplies are needed, drop them onto sterile kit.

11. Put on sterile gloves found in kit. Once your sterile gloves are on you can only touch the supplies on the inside wrapper of the VAD dressing change kit.

12. Open kit further following instructions in kit.

13. Crack cleaning wands. 

14. Scrub driveline insertion site for 30 seconds with first wand. 

15. Then use 2nd wand to clean the length of the driveline and remove any debris.

16. Let the skin and driveline site dry completely.

17. Open the silver plated dressing and lightly dampen with saline wipe.

18. Place dressing silver side down onto driveline insertion site.

19. With the skin prep wand, trace a frame where the cover dressing will go.

20. Place the cover dressing over top of driveline site, ensuring it is secure on all sides and the driveline exit site is in the center of the dressing.

21. Place “pants” to close the dressing around the driveline.

22. Smooth all edges down so that the dressing is secure, then trace with another skin prep wand.

23. Remove sterile gloves and clean hands.

Instructions for securement device dressing change 

Change the securement device once a week or more often if it is not sticking to your child’s skin. This is not a sterile procedure.  

1. Clean the skin underneath your child’s old securement device. You may use leftover soap and water from the dressing change tray. Do not get the dressing wet. 

2. If your child has sensitive skin, consider moving the position of the securement device slightly to the right or left of where the old one was to decrease skin irritation.

3. Remove the backing from the securement device. 

4. Put the new securement device on your child’s skin and secure the driveline. 

5. Clean your hands.

Reviewed 8/6/24 by Catherine Montgomery, BSN, RN, CPN