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Semin Plast Surg 2021; 35(03): 164-170
DOI: 10.1055/s-0041-1731792
Review Article

Negative Pressure Wound Therapy: Mechanism of Action and Clinical Applications

Shanel Normandin
1   Faculty of Medicine, Universite de Sherbrooke, Sherbrooke, Quebec, Canada
,
Tyler Safran
2   Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada
,
Sebastian Winocour
3   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
,
Carrie K. Chu
4   Department of Plastic Surgery, MD Anderson Cancer Center, Houston, Texas
,
Joshua Vorstenbosch
2   Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada
,
Amanda M. Murphy
2   Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada
,
Peter G. Davison
2   Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada
› Author Affiliations
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Abstract

Negative pressure wound therapy (NPWT) promotes healing by evenly applying negative pressure on the surface of the wound. The system consists of a sponge, a semiocclusive barrier, and a fluid collection system. Its effectiveness is explained by four main mechanisms of action, including macrodeformation of the tissues, drainage of extracellular inflammatory fluids, stabilization of the environment of the wound, and microdeformation. Rarely will complications linked to NPWT occur, but special care must be taken to prevent events such as toxic shock syndrome, fistulization, bleeding, and pain. New NPWT modalities have been recently developed to make NPWT suitable for a wider variety of wounds. These include NPWT with instillation therapy (NPWTi-d), different cleansing options, and application of NPWT on primarily closed incisions. Finally, vacuum-assisted wound closure therapy has been demonstrated to be efficient for various clinical settings, such as the management of diabetic foot ulcers, pressure ulcerations, chronic wounds, and skin grafts.

Keywords

negative pressure wound therapy - VAC - wounds - semiocclusive membrane


Publication History

Article published online:
10 September 2021

© 2021. Thieme. All rights reserved.

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