Negative Pressure Wound Therapy is one of the dominant adjunctive wound care modalities used in modern healing. It is a topical treatment using sub‐atmospheric pressure to increase blood flow, remove bacteria and increase growth of granulation tissue in the wound.

• Removing excess fluid (infections and non‐infectious),
• Stimulates granulation by increasing vascular perfusion,
• Encourages wound contraction
• Protects wound from microbe imbalance
• Maintains a moist wound environment

• Pressure ulcers
• Full thickness and partial thickness
• Diabetic/Neuropathetic ulcers
• Venous Insufficiency ulcers
• Post‐operative and dehisced surgical
• Explored fistulas
• Traumatic
• Skin Flaps and Grafts

• Wounds containing malignant tissue
• Untreated osteomyelitis
• Necrotic tissue such as slough or eschar
• Unexplored or non‐enteric fistulas
• Exposed organs, blood vessels

• Active bleeding or anticoagulant therapy
• Proximity of blood vessels, organs, muscle, and fascia requiring protection
• Irradiated vessels and tissue
• Bony fragments
• Untreated malnutrition
• Non‐compliant or combative behavior

• Debridement of wound prior to NPWT
• Off load pressure ulcers consistently
• Minimize time off NPWT to < 4 hours
• Manage co‐morbid condition
• Increase blood flow
• Reduce edema
• Minimize infection
• Control glucose

• Change dressing two/three times per week.
• Monitor frequently
• Observe wound and periwound area for signs and symptoms of infection
• Remove dressings carefully to protect new tissue growth.
• Bright red blood in canister requires immediate evaluation.
• Measure and document per facility protocol

• Increased exudate and wound size during the first 48‐72 hours may be expected due to the decompression of interstitial space and removal of extra‐cellular fluid and debris. Gradual reduction of fluid and surface area should be observed with each assessment.
• Color of wound bed should become a deeper red as perfusion to the site increases.
• Measurements should decrease weekly.
• If healing is not observed in a week, treatment should be re‐evaluated.
• The average treatment with NPWT is 2‐6 weeks. Length of treatment is determined by goals of therapy.

Physician selects therapy settings based on:

• Granulation of the tissue
• Drainage amount
• Wound surface
• Epithelialization
• Pain level
• Healing process