Negative Pressure Therapy (NPWT) for Management of Surgical Wounds: Effects on Wound Healing and Analysis of Devices Evolution.

Infection and wound dehiscence are common complications after surgery and open surgical wounds are difficult to manage. Usually surgical incisions are closed by fixing the edges together. However, in case of significant tissue loss, infected surgical field, or particular cases, wounds may be left open. In recent years, negative pressure wound therapy (NPWT) has been widely used for management of various complicated wounds and to support postoperative tissue healing. Another emerging indication for NPWT, applied directly to the closed incisions, is to prevent infections or dehiscences in patients with increased risk of surgical-site complications (iNPWT). Furthermore, the combination of negative pressure with intermittent instillation of solution (NPWTi) seems to be effective in the treatment of a variety of complex wounds. Even if the role of NPWT in promoting wound healing has been largely accepted, there is a lack of evidence (few high-level clinical studies) regarding its effectiveness and further research is needed to better understand the mechanisms of action. This article contains a review of recent scientific and clinical research related to indications, contraindications, and mechanisms of action of NPWT to clarify current knowledge, technological evolutions, and future perspectives of devices.