Negative-Pressure Wound Therapy: What We Know and What We Need to Know

Abstract

Negative-pressure wound therapy (NPWT) promotes wound healing by applying negative pressure to the wound surface. A quarter of a century after its introduction, NPWT has been used in various clinical conditions, although molecular biological evidence is insufficient due to delay in basic research. Here, we have summarized the history of NPWT, its mechanism of action, what is currently known about it, and what is expected to be known in the future. Particularly, attention has shifted from the four main mechanisms of NPWT to the accompanying secondary effects, such as effects on various cells, bacteria, and surgical wounds. This chapter will help the reader to understand the current status and shortcomings of NPWT-related research, which could aid in the development of basic research and, eventually, clinical use with stronger scientific evidence.

Keywords: Angiogenesis; Biofilm; Epithelial-mesenchymal transition; Mechanotransduction; Microdeformational wound therapy; Surgical site infection; Topical negative pressure; Vacuum sealing drainage; Vacuum-assisted closure; Wound healing.