Negative pressure wound therapy: past, present and future

Abstract

Negative pressure wound therapy (NPWT), which was introduced as a commercial product (V.A.C. Therapy, KCI USA, Inc., San Antonio, TX) less than 20 years ago, has revolutionised the treatment of complex wounds. Indicated for wide variety of wound types, NPWT is an adjunctive therapy that can be used safely in a range of care settings. Current research indicates that there are four primary NPWT mechanisms of action: macrodeformation, microdeformation, fluid removal and environmental control of the wound. The interaction of the primary mechanisms results in secondary effects through cell signalling (e.g. granulation tissue formation, cell proliferation and modulation of inflammation). Better understanding of the mechanisms of action also provides insight into future directions for NPWT research that could create better solutions for patients with complex wounds.

Keywords: NPWT; Negative pressure; Subatmospheric pressure; VAC; Wound healing.

Figure 1

A 34‐year‐old patient with third‐degree burn to her groin and lower abdomen area was treated with negative pressure wound therapy for a 10‐week period. (Photos reprinted with permission from Lauren R. Bayer PA‐C.)

Figure 2

Negative pressure wound therapy combines suction with a foam dressing and a semi‐occlusive drape to keep the wound moist, facilitate fluid removal and stimulate healing at both macrocellular and microcellular levels 1. (Reprinted with permission from Elsevier.)

Figure 3

Future directions for negative pressure wound therapy.