17313 Negative Pressure Wound Therapy

Overview

Negative pressure wound therapy (NPWT) is a way of helping some wounds heal using gentle suction. You may also hear it called 'vacuum-assisted closure' or a 'wound vacuum'. A soft foam or gauze dressing is placed into or over the wound, sealed under a clear film, and connected by a tube to a small pump. The pump gently pulls air and fluid out of the wound area. This steady, gentle suction helps remove extra fluid, draws the edges of the wound closer together, and encourages blood flow, which can help new tissue grow. It is not a medicine and it does not treat the cause of the wound — it is a support that gives the body better conditions to heal.

Yes, negative pressure wound therapy is used quite widely in hospitals, wound clinics, and sometimes at home. It has been used for many years and is a well-established option for hard-to-heal wounds.

It can be used for people of any age, from babies to older adults, whenever a wound is not healing well or has a lot of drainage. It is more often needed by people with conditions that slow healing, such as diabetes, poor circulation, limited mobility, or a weakened immune system, and by people recovering from certain types of surgery or burns.

Symptoms

Common symptoms

• The wound itself may be deep, open, or slow to close, and may produce a lot of fluid or discharge.
• The skin around the wound may look red, swollen, or feel sore.
• You may notice a smell from the wound or see thick or coloured fluid on the dressing.
• The wound may be painful, especially during dressing changes or when the pump is running.
• You may feel tired or generally unwell while your body is working to heal a large wound.

Symptoms in children

• Children may be more upset by the noise of the pump or by having the dressing changed.
• Young children may not be able to explain pain, so watch for fussiness, poor feeding, or trouble sleeping.
• Check that the tubing cannot be pulled or tangled during play or sleep.
• Speak to your child's care team about ways to comfort and distract them during dressing changes.

Symptoms in older adults

• Older adults may heal more slowly and may need longer use of the therapy.
• Confusion or memory problems can make it harder to follow device instructions, so extra support at home is helpful.
• Fragile skin can be irritated by the clear film, so tell your care team about any soreness or redness under the tape.
• Watch for signs of dehydration or poor appetite, which can slow healing.

Causes

Main causes

• Wounds that are slow to heal because of poor blood supply, pressure, or damage to deep tissue.
• Surgical wounds that have opened up or are draining a lot of fluid.
• Diabetic foot wounds and other long-standing leg or foot ulcers.
• Burns, skin grafts, and wounds where skin has been taken from another part of the body.
• Wounds with a lot of fluid or infection that need extra help to clean and close.
• Pressure sores (also called bedsores) in people with limited mobility.

Risk factors

• Diabetes or high blood sugar levels.
• Poor circulation or narrowed blood vessels.
• Smoking, which reduces blood flow and slows healing.
• Being unable to move easily, which can lead to pressure sores.
• A weakened immune system, or treatment that suppresses it.
• Poor nutrition or unintended weight loss.
• Older age and thin, fragile skin.
• Wound infection or repeated trauma to the same area.

When to see a doctor

See a doctor urgently if:

• You notice signs of infection: spreading redness, swelling, heat, pus, or a bad smell.
• You have a fever or feel suddenly unwell.
• There is bleeding that soaks through the dressing.
• The pump is not working, keeps alarming, or the dressing will not stay sealed.
• The pain becomes much worse or is not controlled by the plan your care team gave you.

Book a routine appointment if:

• You have questions about how to use or carry the pump.
• The skin under the clear film becomes itchy, red, or sore.
• You are finding it hard to sleep or manage daily activities with the device.
• You want to know what to expect at your next dressing change.
• You are planning travel and need advice about the pump and spare supplies.

Diagnosis

Negative pressure wound therapy is not a diagnosis — it is a treatment. Your healthcare team decides whether it is right for your wound by looking at the wound, asking about your health and how the wound happened, and checking how well blood is flowing to the area. They will also consider whether the wound needs cleaning, whether infection is present, and whether other treatments might work better.

Tests that may be done

• A careful look and gentle feel of the wound, including its size, depth, and amount of discharge.
• A wound swab or fluid sample if infection is suspected.
• Blood tests to check for infection, blood sugar, and general health.
• An X-ray, ultrasound, or other scan if the team needs to see deeper tissue or bone.
• A check of pulses or blood flow in the limbs, especially for leg and foot wounds.

What to expect at your appointment

Your first appointment usually involves cleaning the wound and placing the dressing, which is then sealed under a clear film and connected to the pump. You will be shown how the machine works, what the alarms mean, and who to contact. The dressing is normally changed every two to three days, though this varies. Your team will check the wound regularly and stop the therapy once the wound is healing well enough, or change the plan if it is not helping.

Treatment

Negative pressure wound therapy is one part of a wider plan to help a wound heal. The plan usually includes keeping the wound clean, treating any infection, managing the condition that caused the wound (such as diabetes or pressure), good nutrition, and regular checks by a nurse or doctor. The therapy itself involves a dressing, a sealed film, tubing, and a small pump that applies gentle suction. Your care team sets the pump and will adjust it as needed — you should not change the settings yourself.

Self-care at home

• Follow the instructions you were given for the pump, including how to charge or replace batteries.
• Keep the pump and dressing dry — cover the device when washing and never let water get into it.
• Check the dressing and seal regularly and tell your team straight away if it lifts or leaks.
• Never pull on the tubing or try to remove or reattach the dressing yourself.
• Take your pain relief as advised by your care team, and tell them if pain is not controlled.
• Eat well and drink enough fluids to support healing, and ask for advice if your appetite is poor.
• Keep moving as much as your team advises, but avoid lying or putting weight on the wound area.
• Carry the pump safely, keep tubing away from small children and pets, and use the carry bag or strap you were given.
• Write down the alarm messages or take a photo if you can, so your team can help quickly.

Medical treatments

Your care team will clean the wound, remove any dead tissue, and place the therapy dressing. They will treat infection if it is present, using treatments prescribed by a doctor, and manage underlying conditions such as blood sugar, circulation, or pressure on the skin. Dressing changes are done by trained staff, usually every two to three days, and the suction settings are set and adjusted by them. The therapy is stopped when the wound has healed enough or when the team decides another approach would work better.

When is surgery considered?

Sometimes a wound needs an operation before or alongside this therapy — for example, to clean out infected or dead tissue, to close the wound, or to place a skin graft. Your team will talk with you about whether surgery is needed and what it involves.

Living with this condition

Most people can carry on with everyday life while using the therapy, but it helps to plan ahead. The pump is small enough to carry, and it makes a soft, steady sound that many people get used to within a few days. You will need spare supplies, a charged battery, and a contact number for your wound care team. Dressing changes are usually done for you, so you will have regular appointments. Ask how the pump should be handled at night, in the bath or shower, and when travelling.

Lifestyle tips

• Wear loose, comfortable clothing that does not press on the dressing or tubing.
• Use the carry bag or strap so your hands stay free and the tubing does not catch.
• Keep the pump away from water, heat, and damp surfaces.
• Plan travel in advance — ask about spare batteries, supplies, and whether the device is safe on planes.
• Avoid smoking, as it slows healing and reduces blood flow.
• Keep follow-up appointments, even if the wound looks better.
• Ask about help at home if lifting, carrying, or dressing changes are difficult.

Diet and exercise

Good nutrition helps wounds heal. Try to eat regular meals with protein (such as beans, lentils, eggs, fish, meat, or dairy), fruit and vegetables, and enough fluids. If you have diabetes, keeping blood sugar steady supports healing — your team can advise you. Gentle movement, such as short walks if you are able, helps circulation, but follow your team's advice about the wound area. Avoid putting weight on a leg or foot wound unless you have been told it is safe.

Mental health and emotional wellbeing

It is very normal to feel frustrated, anxious, or worn down when a wound is taking time to heal. The pump can be a visible reminder of your recovery, and the sound or the tubing may feel intrusive at first. Many people worry about the wound or about getting back to normal life. Talking to your care team, a counsellor, or people you trust can help. If low mood, worry, or sleep problems are affecting you, please tell your doctor — support is available, and asking for it is a sign of strength, not weakness.

Prevention

You cannot always prevent the kind of wound that needs this therapy, but you can lower your risk. Look after your general health, keep blood sugar steady if you have diabetes, avoid smoking, eat well, and stay as active as you can. If you have reduced mobility, change position regularly and check your skin daily for early redness or soreness. Keep any wound clean and covered, follow advice after surgery, and seek help early if a wound is not healing as expected. Catching problems early often means simpler treatment.

Screening programmes

There is no screening test for needing this therapy. Instead, regular wound checks by a nurse or doctor help spot problems early. If you have diabetes or poor circulation, regular foot checks are especially important.

Complications

If left untreated

• The wound may heal more slowly or not close at all.
• Infection can spread into deeper tissue, bone, or the bloodstream.
• Fluid can build up and cause swelling or discomfort.
• In serious cases, severe infection can threaten a limb.
• Longer healing can affect mobility, independence, and quality of life.

Long-term outlook

Many people's wounds improve well with this therapy, especially when the underlying cause is also treated and you get good nutrition and follow-up care. Healing can take weeks or sometimes months, and progress is not always a straight line. Some wounds need other treatments or surgery along the way. Try to focus on small steps, keep your appointments, and raise any worries early — your care team is there to adjust the plan with you, and most people do see progress over time.

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