Vacuum-Assisted Closure of a Wound
What is negative pressure wound therapy or NPWT?
NPWT is a type of therapy to help wounds heal. During the treatment, a device decreases
air pressure on the wound. This can help the wound heal more quickly.
The gases in the air around us put pressure on the surface of our bodies. A wound
vacuum device removes this pressure over the area of the wound. This can help a wound
heal in several ways. It can gently pull fluid from the wound over time. This can
reduce swelling, and may help clean the wound. , It is unclear if it reduces bacteria.
NPWT also helps pull the edges of the wound together. And it may stimulate the growth
of new tissue that helps the wound close.
A NPWT has several parts. A foam or gauze dressing is put directly on the wound. An
adhesive film covers and seals the dressing and wound. A drainage tube leads from
under the adhesive film and connects to a portable vacuum pump. This pump removes
air pressure over the wound. It may do this constantly, or in cycles.
The dressing is changed every 24 to 72 hours. During the therapy, you’ll need to carry
the portable pump everywhere you go.
Why might I need negative pressure wound therapy (NPWT)?
You might need this therapy for a recent traumatic wound. Or you may need it for a
chronic wound. This is a wound that is not healing properly over time. This can happen
with wounds linked to diabetes. You may need NPWT if you’ve had a recent skin graft.
And you may need it for a large wound. Large wounds can take a longer time to heal.
NPWT may help your wound heal more quickly by:
Draining excess fluid from the wound
Keeping your wound moist and warm
Helping draw together wound edges
Increasing blood flow to your wound
Decreasing redness and swelling (inflammation)
NPWT offers some other advantages over other types of wound care. It may decrease
your overall discomfort. The dressings usually need changing less often. And they
may be easier to keep in place.
What are the risks of negative pressure wound therapy (NPWT)?
NPWT has some rare risks, such as:
Proper training in dressing changes can help reduce the risk of these problems. Also,
your healthcare provider will carefully evaluate you to make sure you are a good candidate
for the therapy. Certain problems can increase your risk of complications, such as:
Exposed organs or blood vessels
High risk of bleeding from another health problem
Nearby bone infection
Dead wound tissue
Fragile skin, such as from aging or longtime use of topical steroids
Allergy to adhesive
Very poor blood flow to your wound
Wounds close to joints that may reopen due to movement
Your provider will discuss the risks that apply to you. Make sure to talk with him
or her about all of your questions and concerns.
How do I get ready for negative pressure wound therapy (NPWT)?
You likely won’t need to do much to get ready for NPWT. In some cases, you may need
to wait a while before having this therapy. For example, your provider may first need
to treat an infection in your wound. Dead or damaged tissue may also need to be removed
from your wound.
You or a caregiver may need training on how to use NPWT. This is done if you will
be able to have your therapy at home. In other cases, you may need to have your therapy
in a healthcare facility. If you or a relative will be doing the therapy, you’ll be
trained on how to use the device.
Your healthcare provider will tell you if you need to do anything else to prepare
What happens during negative pressure wound therapy (NPWT)?
A healthcare provider will cover your wound with a foam or gauze wound dressing. An
adhesive film will be put over the dressing and wound. This seals the wound. The foam
connects to a drainage tube, which leads to a vacuum pump. This pump is portable.
When the pump is turned on, it draws fluid through the foam and out the drainage tubing.
The pump may run all the time, or it may cycle off and on. Your exact setup will depend
on the specific type of wound vacuum system that you use.
You may need the dressing changed about once a day. You may need it changed more or
less often depending on your wound. You or your caregiver may be trained to do this
at home. Or it may be done by a visiting healthcare provider. In some cases, it may
be done by a healthcare provider in a hospital or other facility. You may need to
stay in a care facility if you have a large or severe wound.
Your healthcare provider may prescribe a pain medicine. This is to prevent or reduce
pain during the dressing change.
Tell your provider right away if you have a fever or increased swelling or pain in
your wound. Also tell him or her if there is blood or blood clots in the tubing or
collection chamber of the device.
You will likely need to use NPWT for several weeks or months. During the therapy,
you’ll need to carry the portable pump everywhere you go. Your provider will carefully
keep track of your healing.
During this time, make sure you have good nutrition and get enough rest. This is required
for proper wound healing and to prevent infection. Your provider can tell you more
about how to ensure your nutrition during this time.
If you smoke, ask for help so you can stop. The toxic substances in cigarette smoke
(especially nicotine, carbon monoxide, and hydrogen cyanide) greatly impair your body's
ability to heal the wound.
What happens after negative pressure wound therapy (NPWT)?
Follow up with your healthcare provider if you have a health condition that led to
your wound, such as diabetes. He or she can help you prevent future wounds.
Before you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how you will get the results
Who to call after the test or procedure if you have questions or problems
How much you will have to pay for the test or procedure