Negative pressure wound therapy (NPWT / wound VAC)
Some complicated wounds drain heavily, are slow to close, or stay open after an operation. These are treated with a sealed dressing hooked up to steady suction, usually called a wound VAC. It is an add-on treatment: it works alongside debridement and infection control, never in place of them.
Not every wound needs negative pressure. Most heal fine with ordinary dressing changes, and putting the device on a wound that does not need it only adds cost, discomfort and risk. It is considered for wounds like these, and only after the dead tissue has been removed and the infection is under control:
There are situations where this system should not go on, or should not go on yet. It is not applied over dead tissue or hard eschar that has not been cleared away: suction does not debride, and sealing a dirty wound under an adhesive film only makes it worse. It is also not indicated when there is an active infection that is not being treated, a bone infection (osteomyelitis) that is not being treated, a tumor inside the wound, or a fistula that has not been investigated; the foam is not pushed blindly into tunnels or tracts that nobody has explored. The foam is never placed in direct contact with arteries, veins, nerves, bowel, other organs, a vascular graft or an anastomosis: those situations call for a protective layer in between and a careful look at the risk, because erosion in that area can cause severe bleeding. It is used with particular caution in people on blood thinners (anticoagulants), in people with clotting disorders, and when bleeding from the wound was hard to stop in the first place. It also needs supervision: this is not a device to leave running while nobody trained looks at the wound or the equipment. Finally, if the wound has not changed after one to two weeks of treatment that has been done properly, the answer is not to keep going out of habit. The diagnosis, the blood supply to the area, nutrition and diabetes control all get reviewed, because the real cause is usually somewhere else.
The idea is simple: seal the wound and keep steady suction on it. That pulls out fluid that would otherwise collect, takes the swelling out of the edges, draws those edges toward each other, and encourages new tissue and small blood vessels to form. The sealed dressing also keeps the wound away from the outside environment and cuts down how many dressing changes are needed each day.
Negative pressure does not debride a wound, and it does not cure an infection. It is an add-on. If dead tissue is still in there, if the bone is infected, or if the circulation in the leg is not enough to heal anything, the pump will not fix it, and leaving it on only delays the treatment that is actually needed. That is why every dressing change is also a fresh look at the wound, not a routine chore.
Today's pumps are portable, run on a battery and are carried over the shoulder or at the waist, so many patients can walk and get on with much of their normal routine, within whatever the wound and the reason for the surgery allow; for other people movement is more limited, and that is judged person by person. A pulling or squeezing feeling in the area when the pump is running is common, and so is soreness during the first few dressing changes; that is handled with pain medication and, when constant suction is uncomfortable, by switching the pump to cycles. To shower, disconnect the pump for a short while and reconnect it as soon as you are done, keep the spray off the dressing, and do not put the area under water. One rule should not be bent: the system must not sit without suction for more than two hours, because a sealed wound with no suction is a good place for bacteria to multiply. If that does happen, the dressing has to come off and be replaced with a new one; turning the pump back on is not enough. Alarms work the same way, whether it is loss of seal, a full canister or a low battery: deal with them right away and call, rather than leaving it until the next day. Like any treatment, this one carries risks, and some are serious. The main one is bleeding, which can be heavy and has been linked to deaths, above all in wounds near blood vessels, vascular grafts or anastomoses, in groin and breastbone (sternal) wounds, and in people taking blood thinners. Infection can also occur, often tied to pieces of foam left inside the wound, along with softening and breakdown of the skin around the dressing and pain when the foam is peeled away. Go to an emergency room immediately if fresh blood shows up in the tubing or the canister, or if bleeding does not stop. Call the same day if pain is climbing instead of easing, if you have fever or chills, or if there is a bad smell or fluid leaking out from under the film. How long the whole treatment lasts varies a great deal, from a few days in some patients to several weeks in others, and it depends on the size of the wound, on what caused it and on how it responds: no removal date can be promised on the day the pump goes on.
Most people describe a pulling or squeezing feeling while the pump is running rather than pain. What tends to hurt is the dressing change, especially the first one or two. That is handled with pain medication taken beforehand, by wetting the foam so it lifts away more easily and, if needed, by lowering the pressure or switching to cycle mode. Say something if it hurts, because an adjustment can almost always be tried. And if the pain is climbing instead of settling, call without waiting for the next appointment.
The dressing is usually changed every 48 to 72 hours, and sooner if the wound drains heavily, if there is infection, or if the seal is lost; over a skin graft it is normally left alone until the check the surgeon has already scheduled. How long the therapy runs in total depends on the wound, and no number can be promised: some wounds need a few days, others several weeks. What is fixed is the review. If the wound has not changed after one or two weeks, the treatment gets rethought rather than simply continued.
Yes, carefully. Disconnect the pump for a short while, keep the spray off the dressing, and do not put the area under water, so no tub, pool or ocean. The film handles water, but the seal is what the whole treatment rests on and it is not worth testing. And do not leave the pump disconnected for more than two hours: if that happens, the dressing has to be changed, not just plugged back in.
Many patients use it at home with a portable unit and come in only for dressing changes. That works when the patient or a family member knows what to do when an alarm goes off and who to call: the serious complications reported with this therapy have happened mostly in people treated at home or in nursing facilities, where there are fewer eyes on the wound. Other patients need to be admitted, particularly at the start, when the wound is extensive or an infection is being treated with intravenous antibiotics. It is decided case by case.
Raise it early, before you book anything, because it has to be planned rather than improvised. Airlines generally allow battery-powered medical devices, but confirm it with yours and ask about spare batteries and charging in the cabin. The bigger question is who picks up the treatment at the other end: someone there has to change the dressing, answer an alarm and reassess the wound, and the two-hour rule does not pause for a flight or a layover. The operative report, culture results and a written summary of the therapy are provided for whoever receives you. If the wound bleeds easily or an infection is still being treated, travel waits.
That usually depends on your policy and on whether the treatment follows an operation or condition that is covered. Patients with major medical expense insurance are seen, and the medical report and whatever documentation your insurer asks for are provided. If your policy was issued outside Mexico, check before treatment starts whether the insurer pays the provider directly or whether you pay and claim it back, since many international plans work by reimbursement. The answer comes from your insurer, not from this office.
If you have a wound that will not close, one that opened up after an operation, or one draining more than you expected, the first thing is for someone to look at it and decide what it needs. It may be negative pressure, or it may be debridement, antibiotics or a check of the circulation in the area. Heavy bleeding, high fever or pain that is growing fast is an emergency and should not wait for an appointment. The assessment visit costs $800 MXN (Mexican pesos), and consultations are in English or Spanish. The office is at De Los Tules 168-10, Jardines de Las Gaviotas. If you have earlier imaging, culture results or the operative report from surgery done elsewhere, bring them with you.
Laparoscopic Cholecystectomy
If you have gallstones or recurring pain after eating, laparoscopic gallbladder removal is a safe, common procedure with a fast recovery. Performed by a board-certified General Surgeon with specific training in minimally invasive techniques.
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Gallstones and gallbladder inflammation (cholecystitis) usually present recognizable signs. If you have several of these symptoms, especially after fatty meals, it is worth getting evaluated:
Not all gallstones require immediate surgery, but it is recommended when there are recurring symptoms, large stones, gallbladder inflammation, or risk of complications such as bile duct obstruction or pancreatitis. In consultation, your specific case is evaluated based on your symptoms, imaging studies (such as ultrasound), and medical history to determine if surgery is the best option for you.
Laparoscopic cholecystectomy is the current standard technique — performed through 3 to 4 very small incisions instead of one large cut, which reduces postoperative pain and speeds up recovery.
Procedure duration: Between 45 and 90 minutes in most cases. Most patients are discharged 24 to 48 hours after surgery.
One of the major advantages of the laparoscopic technique is fast recovery. Most patients resume light activities in 3 to 5 days and normal activities in 1 to 2 weeks. The human body functions perfectly without a gallbladder — the liver continues producing the bile needed for digestion.
Most patients report mild to moderate pain in the first 2-3 days, controlled with common pain relievers. Because it is laparoscopic, the pain is considerably less than with open surgery.
Yes, completely. The gallbladder stores bile but is not essential — the liver keeps producing the bile needed to digest fats normally.
The cost varies depending on the hospital, room type, and whether you have major medical insurance. At the initial consultation ($800 MXN) you receive a complete, transparent quote.
Yes, major medical insurance is accepted in addition to self-pay.
Yes, the consultation and the entire surgical process are available in fluent English.
Book your consultation and get a clear evaluation of your specific case.
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