Modern wound therapy is developing continuously. Vacuum therapy is an established procedure to treat wounds. Available on the market is, among others, the V.A.C. (Vacuum Assisted Closure) therapy system. Here, we report the various effects of the vacuum therapy on wounds such as reducing the bacterial contamination, improving granulation and microcirculation and focus on the practical use of the V.A.C., possible complications, contraindications and the economic aspects of the therapy. Since V.A.C. therapy allows rapid mobilization of patients especially with postoperative or posttraumatic wounds, infrequent dressing changes and relative analgesia, this treatment modality is well-accepted by patients with acute or chronic wounds. One explanation for the high acceptance on part of the therapists and the widespread use of the method are the excellent clinical results.