Lidocaine analgesia for removal of vacuum-assisted closure dressings

Bedside removal of the reticulated polyurethane foam used in vacuum-assisted closure can be very painful despite the use of interface dressings to reduce wound bed adherence. We describe a simple preprocedural step at the bedside where a bolus of lidocaine 1% (3 mg/kg) is injected through the occlusive dressing overlying the foam 15 minutes prior to removal. The adaptor is first closed and suction canister turned off. Next, the dressing is cleansed using an alcohol wipe and finally the lidocaine is injected. This extra step reduces requirements for analgesia and can obviate the need for general anaesthesia in small to medium-sized wounds.