[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Procedures](https://durgical.com/en/nursing/areas/procedures/) › Negative-pressure wound therapy

# Negative-pressure wound therapy

- Procedure

A sealed foam dressing connected to a vacuum pump removes fluid and draws the wound edges together; the seal and the pump must keep working.

Updated Nov 12, 2026

## Key points

- When it works, the foam is collapsed and the pump shows no alarm; a lost seal means the therapy is not working.
- The pump runs most of the day; do not leave it switched off, and report any interruption you cannot fix.
- Bright red blood in the tube or canister is an emergency, especially with anticoagulants.
- Dressing changes are commonly every 48 hours, or sooner if the seal is lost or the order says so.
- Route the tube so the patient does not lie on it: tubing can cause pressure injuries.

## What it is

Negative-pressure wound therapy places a foam dressing in the wound, seals it with an adhesive film and connects it through a tube to a pump that applies pressure below atmospheric pressure. The suction removes exudate, reduces oedema, improves local blood flow, promotes granulation tissue and helps the wound contract. The pressure, the mode and the dressing-change schedule are ordered by the treating team. The nurse checks the seal, the alarms, the canister and the patient, and changes the dressing when trained to do so.

## Indications

- Chronic or complex wounds: pressure injuries and diabetic foot ulcers.
- Wound dehiscence.
- Fixing skin grafts and flaps.
- Open abdomen and other complex surgical wounds, managed by the specialist team.

## Contraindications and precautions

- Contraindications: cancer in the wound, untreated osteomyelitis, necrotic tissue with eschar (it is debrided first) and exposed blood vessels.
- Precautions: active bleeding, difficult haemostasis or anticoagulant treatment.
- Vessels and organs near the wound must be protected by a barrier; take extra care with irradiated, weakened or sutured vessels.
- Sharp bone fragments or edges can damage the barrier.
- The skin around the wound must be intact enough to hold the seal.

## Equipment

- Pump with canister and tubing, set as ordered.
- Foam of the type ordered, sterile scissors and adhesive film.
- Sterile saline, sterile gloves and gauze for cleaning.
- Skin protectant; a thin hydrocolloid under the film if the skin does not tolerate it.
- Record for settings and drainage.

## Step by step (and why)

- Check the order and settings, identify the patient and offer prescribed pain relief before a change — changes can hurt.
- Switch off the pump and peel the film gently, cutting it along the foam edge if the skin is fragile — protects the skin.
- Clean the wound with saline and assess bed, edges, exudate and surrounding skin — documents the progress.
- Protect the surrounding skin and cut the foam to the wound's shape — the film needs dry, intact skin to seal.
- Cover with film that extends well beyond the edges onto dry skin, with no wrinkles — a wrinkle lets air leak in.
- Attach the tube where the patient will not lie on it and change its direction each time — prevents pressure injuries.
- Start the pump as ordered and check the foam collapses with no alarm — confirms the seal.
- On every round check seal, alarms, canister level, drainage colour and pain — bright red drainage means bleeding.
- Record date, settings, wound condition and drainage — allows safe follow-up.

## Complications

- Bleeding, especially with anticoagulants or after debridement.
- Infection; odour can come from infection or from fluid in the foam.
- Maceration or irritation of the surrounding skin and intolerance to the film.
- Pain during therapy or dressing changes.
- Pressure injuries from the tubing.

## Next step: when to call for help

- Stop the pump and call at once if bright red blood appears in the tube or canister, or the drainage increases suddenly.
- Call if the seal cannot be restored or an alarm persists: the therapy is not working.
- Call for fever, pus, spreading redness, a new bad odour or a wound that gets worse.
- Call if pain is not controlled: the team may adjust the pressure.

## Test yourself

Think of the answer, then tap the question to see it.

## How does negative-pressure therapy help a wound heal?

The suction removes exudate, reduces oedema, improves blood flow, promotes granulation tissue and draws the wound edges together.

## How can the nurse tell that the seal is working?

The foam is collapsed under the film and the pump shows no leak alarm.

## What are two contraindications to negative-pressure wound therapy?

For example cancer in the wound, untreated osteomyelitis, necrotic tissue with eschar or exposed blood vessels.

## Why is the direction of the tubing changed at each dressing change?

Because tubing that stays on the same patch of skin can cause a pressure injury; securing it on the film and moving it each time prevents this.

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## Connections

## Related 4

- [Wound care and dressings: cleaning and choosing a dressing](https://durgical.com/en/nursing/wound-care-and-dressings-cleaning-and-choosing-a-dressing/)
- [Wound assessment: bed, edges, exudate and signs of infection](https://durgical.com/en/nursing/wound-assessment-bed-edges-exudate-and-signs-of-infection/)
- [Caring for an existing pressure injury by stage](https://durgical.com/en/nursing/caring-for-an-existing-pressure-injury-by-stage/)
- [The surgical wound: healing, dehiscence and infection](https://durgical.com/en/nursing/the-surgical-wound-healing-dehiscence-and-infection/)

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Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.

Sources: [Nursing Skills, 20.5: Wound Dressings](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Skills_(OpenRN)/20%3A_Wound_Care/20.05%3A_Wound_Dressings) (Open RN (Chippewa Valley Technical College), LibreTexts, 2021); [Intervención de enfermería en pacientes con sistema de cierre estimulado por vacío (Gualteros Castiblanco E, Correal Pachón M)](https://encolombia.com/medicina/revistas-medicas/enfermeria/ve-92/enfermeria9206-intervencion1/) (Revista Actualizaciones en Enfermería, Fundación Santa Fe de Bogotá, 2006).

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Source: https://durgical.com/en/nursing/negative-pressure-wound-therapy/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/negative-pressure-wound-therapy/