Published online Feb 2, 2017. doi: 10.5314/wjd.v6.i1.1
Peer-review started: September 27, 2016
First decision: October 15, 2016
Revised: December 16, 2016
Accepted: January 11, 2017
Article in press: January 12, 2017
Published online: February 2, 2017
Vacuum-assisted closure, sometimes referred to as microdeformational wound therapy or most commonly negative pressure wound therapy (NPWT), has significantly improved wound care over the past two decades. NPWT is known to affect wound healing through four primary mechanisms (macrodeformation, microdeformation, fluid removal, and alteration of the wound environment) and various secondary mechanisms (including neurogenesis, angiogenesis, modulation of inflammation, and alterations in bioburden) which are described in this review. In addition, the technique has many established uses, for example in wound healing of diabetic and pressure ulcers, as well as burn and blast wounds. This therapy also has many uses whose efficacy has yet to be confirmed, for example the use in digestive surgery. Modifications of the traditional NPWT have also been established and are described in detail. This therapy has various considerations and contraindications which are summarized in this review. Finally, future perspectives, such as the optimal cycling of the treatment and the most appropriate interface material, are touched upon in the final segment. Overall, despite the fact that questions remain to be answered about NPWT, this technology is a major breakthrough in wound healing with significant potential use both in the hospital but also in the community.
Core tip: Negative pressure wound therapy has been very beneficial in the wound care of many different kinds of wounds, from pressure ulcers to open fractures mostly due to its mechanism of action which we explain in detail. We explain the original purpose of this technology and going into detail about the many different ways it is currently being used in a clinical setting. Our review also explains its advantages and disadvantages and how they could be overcome. The last part of this review discusses the future of this technology and how it will keep impacting the field of wound care.