A consensus report on the use of vacuum-assisted closure in chronic, difficult-to-heal wounds.

Vacuum-assisted closure is an adjunctive therapy that utilizes negative pressure to remove fluid from open wounds through a sealed dressing and tubing which is connected to a collection container. Although introduced into practice for individuals with chronic wounds, evidence to support its use is limited. To compensate for the current gap between the evidence base and the need for best vacuum-assisted closure practices in the treatment of chronic wounds, the existing evidence base (case reports, case series, and studies) for pressure ulcers, diabetic foot ulcers, heel ulcers, and venous leg ulcers was retrieved and tabulated from relevant literature in PubMed and other sources. In addition, expert opinion was obtained through an 11-member Delphi panel of interdisciplinary wound care opinion leaders and educators. The panel included frequent (6) and less-frequent (5) vacuum-assisted closure users. The tabulated responses and the existing literature formed the basis of the best practice statements that serve to guide treatment approaches and stimulate further study.