Get and Sign Kci Wound Vac Form . LIT 29-K-105 Patient Name D. O. B. // Completed by 5a Clinical Information by Wound Type Was NPWT initiated in an inpatient facility Yes No Date Initiated // OR has the patient been on NPWT anytime during the last 60 days Is the patient s nutritional status compromised Facility City St If yes check the action taken Protein Supplements Enteral/NG Feeding TPN ....