This is a wound treatment method which has some significant advantages over the traditional methods of treatment. Method includes the establishment of the controlled negative pressure in the wound bed and pressure maintenance at a preset level that permits to close a wound defect quickly and effectively, and transfer the patients into outpatient treatment, when they will continue to receive a qualified medical care without the necessity to make frequent visits to the doctor.

Functional principle of vacuum wound therapy (NPWT)

 The principle of vacuum wound therapy (NPWT) is to generate a negative pressure at a specific, preset level over the entire area of wound chamber or wound surface using an open porous polyurethane foam sponge inserted into the wound chamber. To prevent air absorption from the external environment, wound and the filler, located inside the wound or on the wound, are hermetically sealed with an adhesive film which is permeable for water vapor, transparent and bacteria protected. Then drainage is applied to a small hole made in the film surface and connected to a vacuum source using a tube (Fig. 1, Fig 2).

 NPWT’s mode of action

 The following wound chamber effects resulting from the use of negative pressure, which is applied uniformly to the entire wound surface, are considered as the main clinically significant advantages of NPWT. (2-10) 23, 25, 29-35

 Wound effect

• Reduction of wound area due to the use of negative pressure applying to the polyurethane foam sponge, strapping of wound edges (wound retraction);

• Stimulation of granulation tissue formation in an optimally humid wound environment; in some situations, NPWT may stimulate granulation tissue formation even over bradytrophic tissue, such as tendons and bones.

• Continuation of the effective mechanical wound cleaning (removal of small tissue residues by suction).

• Effective biochemical decrease in concentration of liquid proteases that impede wound healing (such as elastase) in the first days.

• Reliable, continuous removal of wound exudate (and, therefore, a reduced number of dressing changes) in a closed system.

• Pressure related reduction of interstitial edema with a consistent improvement of microcirculation, blood stimulation and oxygenation.


Patient management

• Hygienic wound suturing – bacteria-protected dressing for wound sealing to protect the wound from the penetration of any external bacteria and spreading of patient’s inherent wound bacteria.

This is especially important in case of infection with problem bacteria, as in patients with wounds infected with methicillin-resistant Staphylococcus aureus (MRSA). Thus, it also reduces the risk of cross infections and the resistance development in the hospital.

• A transparent dressing allows a continuous clinical monitoring of the surrounding skin through the film used for wound suturing.

• Odorless hygienic dressing technique; a constant leakage through dressing to the patient’s clothes and bedding items may be avoided, reducing the requirements to the medical personnel.

• Reduction in the number of dressings required (change of dressings is required every three days only) that reduces any care needs, especially in patients with exudative wounds.

Patient comfort

• Simple and early patient mobilization

• Visually attractive dressing method due to clean, exudate-free dressing conditions, even during mobilization.


References used in the article:

1. Apelqvist, J., Willy, C., Fagerdahl, A.M. et al. Negative Pressure Wound Therapy - overview, challenges and perspectives. J Wound Care 2017; 26: 3, Suppl 3, S1- S113.

2. Fleischmann, W., Becker, U., Bischoff, M., Hoekstra, H. Vacuum sealing: indications, technique and results. Eur J Orthop Surg Traumatol 1995; 5: 37-40. Medline doi:10.1007/BF02716212

3. Argenta, L.C., Morykwas, M.J. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg 1997; 38: 6, 563-577.

4. Banwell, P.E., Teot, L. Topical negative pressure (TNP): the evolution of a novel wound therapy. J Wound Care 2003; 12: 1, 22-28.

5. Armstrong, D.G., Lavery, L.A., Abu-Rumman, P. et al. Outcomes of subatmospheric pressure dressing therapy on wounds of the diabetic foot. Ostomy Wound Manage 2002; 48: 4, 64-68.

6. Deva, A.K., Buckland, G.H., Fisher, E. et al. Topical negative pressure in wound management. Med J Aust 2000; 173: 3, 128-131.

7. Avery, C., Pereira, J., Moody, A., Whitworth, I. Clinical experience with the negative pressure wound dressing. Br J Oral Maxillofac Surg 2000; 38: 4, 343-345. Medline doi:10.1054/bjom.1999.0453

8. Banwell, P.E. Topical negative pressure therapy in wound care. J Wound Care 1999; 8: 2, 79-84.

9. Banwell, P., Holten, I., Martin, D.L. Negative pressure therapy: clinical applications and experience with 200 cases. Wound Repair Regen 1998; 6: 460.

10. Fleischmann, W., Lang, E., Russ, M. [Treatment of infection by vacuum sealing]. [Article in German] Unfallchirurg 1997; 100: 4, 301-304.

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