Use of vacuum-assisted closure negative pressure wound therapy in combat-related injuries--literature review.

Despite surgical and technological advances, managing combat-related injuries remains challenging both within and outside of the war theater. Unique characteristics of a war theater such as environmental contamination, varying evacuation procedures, and differing levels of medical care, add to the complexity. The advent of body armor has increased blast survival rates and soldiers are surviving with increasingly mangled limbs that require lengthy, multifaceted care. An inherent high risk of infection contraindicates immediate closure for these wounds. There is growing reported use of negative pressure wound therapy with reticulated open-cell foam (NPWT/ROCF) as delivered by vacuum-assisted closure (VAC) therapy (KCI Licensing Inc., San Antonio, TX) as an adjunctive therapy in these open soft-tissue combat wounds. This review evaluates the efficacy of NPWT/ROCF for adjunctive treatment of wartime wounds. Following a literature review, data are summarized and presented.