Negative pressure wound therapy (NPWT / VAC)
Negative pressure wound therapy uses a sealed dressing connected to a device that applies gentle, continuous suction. It can help with some complex wounds, but it needs careful patient selection and close follow-up.
This information is general education and does not replace an individual medical assessment. Do not change your treatment or dressings without speaking to your care team.
What is negative pressure wound therapy?
It is often called “VAC therapy”, a name that comes from one brand. The clinical term is negative pressure wound therapy, or NPWT.
The system has a filler (foam or gauze) placed in the wound, a transparent adhesive film that seals it, and tubing connected to a small pump that creates pressure below atmospheric pressure, with a canister that collects fluid.
How does it help?
- It continuously removes excess fluid from the wound.
- It helps draw the wound edges together.
- It keeps the wound in a closed, moist environment.
- It may support the growth of healthy granulation tissue in the wound bed.
- It may mean fewer dressing changes than some conventional dressings.
The treating team sets the pressure level, the type of filler and the length of treatment for each wound and patient.
When may it be used?
The treating team may decide to use NPWT for wounds such as:
- Complex surgical wounds, or wounds that have opened after surgery.
- Some diabetic foot wounds after surgical debridement.
- Some deep pressure injuries.
- Securing skin grafts.
- Some large traumatic wounds.
Smaller systems also exist for use over closed surgical incisions in some patients at higher risk of complications, at the surgeon’s discretion.
When is it not suitable?
NPWT is not used, or is used only with great caution under direct medical supervision, in situations including:
- Exposed blood vessels, organs or nerves in the wound.
- Untreated bone infection (osteomyelitis).
- Cancer in the wound.
- Dead tissue or black eschar that has not been removed.
- An unexplored fistula.
- A high risk of bleeding, for example in patients on blood thinners or with clotting problems.
The decision to start or stop treatment rests with the physician and the treating team after a full assessment.
What does follow-up involve?
- Regular dressing changes by a trained person, often every two to three days depending on the team’s plan.
- Responding to alarms: air leaks, a full canister, a blocked tube or a low battery.
- Not leaving the device switched off for long. Follow your team’s instructions on how long is allowed, and contact them if therapy stops.
- Watching the colour and amount of fluid, signs of infection and pain.
- Recording wound measurements to see whether treatment is making progress.
Contact the treating team immediately or go to the emergency department if you see bright red blood in the tubing or canister, or the canister fills quickly with blood.
Daily life with the device
- You may feel a gentle pulling when it starts, which usually eases soon. Tell the team in advance if dressing changes are painful.
- Carry the device in its bag, avoid pulling, kinking or sitting on the tubing, and place it safely at night.
- Never put the device in water; ask the team how to wash safely.
- Don’t disconnect the device or change the dressing yourself.
| Alarm | What to do |
|---|---|
| Air leak | Check the dressing edges and press gently on the film. If the alarm continues, contact the team. |
| Canister full | Contact the team to change the canister. |
| Blockage | Make sure the tubing isn’t kinked and the clamps are open. If the alarm continues, contact the team. |
| Low battery | Plug the device into its charger. |
The specialist nurse’s role
NPWT requires skill in applying and sealing the dressing, protecting the surrounding skin and managing alarms, in coordination with the physician and the multidisciplinary team. Hands-on training in the fundamentals is available for nursing teams.
Educational videos
Watch the educational videosShort wound-care explainers on InstagramA multidisciplinary team
A complex wound is never treated by one specialty alone. Care is coordinated with a multidisciplinary team according to each case, because healing depends on treating the cause: circulation, infection, pressure, nutrition and the need for surgery.
- Orthopaedic surgery
- Vascular surgery
- General surgery
- Plastic and reconstructive surgery
- Podiatry
- Infectious diseases
- Clinical nutrition
- Other healthcare professionals as each case requires
Get in touch
For patients and families: discuss any change to your care plan with your treating doctor or care team.
For enquiries, training and collaboration with healthcare teams and facilities across Jordan.
Related pages
References
- Apelqvist J, Willy C, Fagerdahl AM, et al. EWMA Document: Negative Pressure Wound Therapy. Journal of Wound Care. 2017;26(Sup3):S1–S154.
- Atkin L, Bućko Z, Conde Montero E, et al. Implementing TIMERS: the race against hard-to-heal wounds. Journal of Wound Care. 2019;28(Sup3a):S1–S50.
- International Wound Infection Institute (IWII). Wound Infection in Clinical Practice: Principles of Best Practice. International Consensus Update 2022. Wounds International.
- National Institute for Health and Care Excellence (NICE). Surgical site infections: prevention and treatment (NG125). 2019, updated 2020.
Independent content
Independent content: Content on this website is educational and independent and does not promote any brand. Product choices for any patient follow clinical assessment and the treating team’s plan.