Summary: Published in the November/December 2025 issue of the Journal of Wound, Ostomy and Continence Nursing (JWOCN, LWW; DOI: 10.1097/WON), this article examines the clinical use of negative pressure wound therapy (NPWT) across selected wound types, addressing questions of appropriate patient and wound selection, individualised treatment goal-setting, and clinical outcomes. NPWT — also known as vacuum-assisted closure (VAC) — applies sub-atmospheric pressure to the wound environment through a sealed dressing and suction device, promoting healing through multiple mechanisms: removal of wound exudate and infectious material, reduction of localised oedema, mechanical stimulation of granulation tissue formation, approximation of wound edges, and enhancement of local blood flow and angiogenesis. JWOCN has published multiple practice-shaping NPWT studies, including prior work demonstrating that single-use NPWT systems can achieve individualised therapy goals across heterogeneous wound types including diabetic foot ulcers, pressure injuries, abscess wounds, necrotising fasciitis, and non-healing post-surgical wounds, with attending clinicians selecting specific endpoints (wound volume reduction, tunnelling reduction, slough reduction, granulation tissue increase) at baseline. This November 2025 article extends that body of evidence with a focus on appropriate wound-type selection and clinical application in practice. As the journal is behind a paywall and robots.txt restricted direct access, the full author list and specific results require institutional or LWW subscription access. Clinicians and wound care professionals can access the full article via LWW or through institutional library subscriptions.
Key Highlights:
- NPWT mechanism overview: sub-atmospheric pressure promotes wound healing by removing excess exudate, reducing oedema, mechanically stimulating granulation tissue, approximating wound edges, and improving local perfusion — with efficacy across a broad spectrum of wound types
- Patient/wound selection: appropriate NPWT candidate identification is central to this article’s contribution — not all wound types respond equivalently, and contraindications (exposed vessels, organs, untreated osteomyelitis, malignancy in wound bed, dry/necrotic wounds) must be carefully evaluated
- Goal-directed therapy model: prior JWOCN research demonstrated the utility of selecting a single, attending-defined therapy endpoint per patient (volume, tunnelling, slough, granulation, periwound swelling) rather than uniform outcome metrics — allowing personalised efficacy assessment
- Wound type applicability: NPWT evidence base includes diabetic foot ulcers, pressure injuries, abscess/cyst management, necrotising fasciitis, non-healing post-surgical wounds, and venous ulcers with compression bridges — each with distinct evidence quality and protocol considerations
- Single-use NPWT systems: smaller, disposable NPWT devices have expanded the setting of care beyond hospital-based VAC, enabling ambulatory wound clinic and home-based application — increasing access for patients with mobility limitations or remote locations
- Access note: this article is published behind the LWW/Ovid paywall; full text including complete author list, methods, and results requires institutional or individual JWOCN subscription access at journals.lww.com/jwocnonline
Keywords: negative pressure wound therapy, NPWT wound types, vacuum assisted closure wound care, wound ostomy continence nursing, NPWT diabetic foot ulcer, single use NPWT