Negative Pressure Wound Therapy

Negative pressure wound therapy (NPWT) uses a sealed dressing and controlled suction to create subatmospheric pressure at the wound surface. It removes exudate, reduces edema, and supports granulation through macrodeformation of wound edges and microdeformation of cells. NPWT may be used for stage II–IV pressure injuries, chronic non-healing wounds, surgical incisions, flaps, skin grafts, and wounds that have not responded to standard moist dressings when the wound is suitable. It is an adjunct, not a substitute for debridement, hemostasis, infection treatment, perfusion assessment, pressure off-loading, or nutritional support. For the RPN, the safe sequence is to verify the ordered plan within local policy, confirm the wound is appropriate, inspect the system and patient at the required intervals, and escalate changes that suggest bleeding, infection, tissue damage, or therapy failure. The mechanism makes the reason for surveillance clear: the same suction that removes fluid can cause harm if the wound bed or seal is unsafe.