Use of Negative Pressure to Promote Wound Healing

Negative pressure wound therapy (NPWT) or vacuum-assisted closure (VAC) involves the application of subatmospheric (negative) pressure to a wound. This technology was initially developed for use within the human medical field for management of chronic, nonhealing wounds – in particular those associated with diabetes. The last decade has witnessed marked expansion of the availability of these devices and advances in development of topical wound components. The spectrum of clinical application has evolved to include acute traumatic wounds, augmentation of open and closed surgical wounds, sternal osteomyelitis and mediastinitis, skin flap salvage, free graft buttressing and septic peritonitis. Negative pressure wound therapy has also revolutionised the ability of battlefield trauma clinicians to manage injuries in military personnel.

Open cell polyurethane ether foam or gauze is placed within the wound bed (an interposing nonadherent contact layer may be used in the case of free skin grafting) and a semi-permeable adhesive drape is applied to create a closed environment. This system is connected via an evacuation tube to a collection canister to allow contained accumulation of wound exudates. Pressure levels and application cycles are programmable and auto-regulated. […]