Negative-pressure wound therapy (NPWT) has been a major advance in the management of open wounds, especially in orthopedic trauma surgery. Due to the success of NPWT, surgeons began using NPWT on closed incisions as a way to help prevent surgical wound dehiscence, especially in at-risk patients for wound problems. It has been well established that obesity, diabetes mellitus, and smoking in addition to other comorbidities increase the risk of wound dehiscence and surgical site infections in orthopedic patients. This article reviews the current literature and provides an overview on the use of NPWT on closed incisions in orthopedic trauma procedures and joint arthroplasty.