Negative pressure wound therapy (NPWT)

Status: Decision completed

Policy context

Negative pressure wound therapy (NPWT) is used in the treatment of slow or nonhealing wounds. Home use of NPWT includes use of a portable device. Concerns are considered medium for safety, medium/high for efficacy, and medium for cost-effectiveness.

Primary criteria ranking

  • Safety = Medium
  • Efficacy = Medium/ High
  • Cost = Medium

Assessment Timeline

  • Draft key questions published: May 2, 2016
  • Public comment period: May 3, to 17, 2016
  • Final key questions published: May 27, 2016
  • Draft report published: Aug 18, 2016
  • Public comment period: August 19, to September 19, 2016
  • Final report published: October 14, 2016
  • HTCC public meeting: November 18, 2016


Chronic wounds include venous ulcers, diabetic foot ulcers, and pressure sores, with causes that are related to venous insufficiency, pressure, trauma, diabetes, vascular disease, and immobilization. Although the causes for chronic wounds vary, in all cases, at least one of the phases of wound healing is compromised. Negative pressure wound therapy (NPWT), also referred to as subatmospheric pressure wound therapy or vacuum-assisted wound therapy, involves the application of subatmospheric pressure to the open wound with the goal of creating a controlled, closed wound amenable to surgical closure, grafting, or healing by secondary intention. NPWT is thought to promote wound healing by providing a warm, moist wound bed while removing wound fluid. This removes molecular factors that inhibit cell growth, improves blood flow to the wound, enhances wound oxygenation, and also improves the flow of nutrients to the wound. NPWT may also create mechanical forces that influence the wound macroscopically, by drawing the wound edges together, and microscopically, by exerting mechanical forces on tissue that induce cell proliferation, cell migration to the wound, and angiogenesis.