Introduction
This document provides instructions for the manual operation of a Negative Pressure Wound Therapy (NPWT) system, updated as of January 7, 2024. The system is designed to aid in wound healing by applying negative pressure to the wound area.

Preparation
Ensure there is a 5-10 cm margin of healthy skin around the wound for adhesive application. Clean, debride, and dry the wound and surrounding skin thoroughly.

Application Procedure
1. Place the adhesive plaster over the wound.
2. Remove the side protective layer (labelled 2) slowly.
3. Remove the top protective layer (labelled 3) and press the dressing to secure it.
4. Cut a 2 cm diameter hole in the plaster using sterile scissors.
5. Open the NPWT dressing in a sterile environment and cut the foam to fit the wound size and shape, ensuring cuts are made away from the wound.
6. Remove the lower protective layer (labelled 1) and apply it to the adhesive plaster on the foam.
7. Place the foam in the wound, ensuring it covers the wound without extending onto healthy skin.

Dome and Device Connection
1. Affix the dome onto the plaster, aligning its holes with the plaster hole.
2. Remove the top protective layer (labelled 2) from the dome.
3. Apply another adhesive layer over the dome to prevent leaks.
4. Connect the PragmaVAC device to the wound tube and press the button until color strips disappear, indicating active negative pressure treatment.

Maintenance and Monitoring
1. Instruct the patient or caregiver to press the button whenever the red strip appears, typically every few hours.
2. Wrap the limb with gauze or bandage to protect the plaster.
3. If fluid accumulates in the canister, empty, wash, and reseal it tightly. Record the fluid quantity.

Recommendations
Regular monitoring and maintenance are crucial for effective therapy. Ensure all components are securely affixed and check for leaks regularly.