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If you have a wound that’s not healing, your doctor may suggest a treatment called vacuum-assisted closure (VAC). Some health care professionals call it negative pressure wound therapy (NPWT). The procedure works by applying suction to the wound area. Here’s what you need to know about VAC.

What Is Vacuum-Assisted Closure?

Sometimes wounds don’t close well when they’re healing. VAC helps healing by using suction to encourage new tissue to grow in the wound. The process also removes bacteria and excess fluid from the wound, which helps it heal faster.

You may have the treatment in the hospital, or you may go home with the vacuum device. At home, a nurse will check in with you and change the wound dressing several times a week.

How VAC works

VAC uses mild suction to help the wound heal. Here’s how it works:

• First, a nurse cleans and dries the wound.
• Then, they insert a special piece of foam into the wound. The foam has a tube sticking out of the top.
• The nurse covers and seals the wound area with an adhesive covering, with just the tube exposed.
• The tube connects to a vacuum pump, which creates a gentle suction.
• The pressure sucks air out of the foam dressing, which causes it to collapse inward.
• That slight pressure pulls fluid from the wound and helps new cells grow.
• The fluid flows into a disposable canister.

Benefits of Vacuum-Assisted Closure

You may feel a mild pulling sensation at first, but you shouldn’t feel pain from VAC. The treatment can help:

• Reduce the size of the wound. When the wound area is smaller, it’s easier for the edges to come together and heal.
• Remove extra fluid. Edema is the buildup of fluid, or swelling, around a wound. It’s common after surgery and in large wounds, and it slows cell growth in the wound.
• Prevent infection. By clearing away fluid, you reduce the amount of bacteria around the wound. That lowers the risk of infection and promotes healing.
• Increase blood flow to the wound. This extra blood moving around the wound speeds recovery. It brings more oxygen to the wound and takes away dead cells and bacteria.
• Lead to new tissue growth. VAC stimulates growth of new tissue around the wound.

Who’s a Good Candidate for Vacuum-Assisted Closure?

Your doctor may recommend VAC if have a deep, chronic wound or if you’re staying in the hospital for a prolonged period of time.

“We’re not talking about the kind of healing after a routine cut or scrape, or even after a routine surgical procedure,” Dr. J. Peter Rubin, MD, director of Wound Healing Services at UPMC, told WPXI. “We’re talking about patients who have very difficult-to-heal wounds because they have chronic disease states or other difficult medical problems that keep these wounds from healing.”

Your doctor may also recommend VAC if you have:

• Diabetic ulcers, which are typically hard to heal.
• Severe burns.
• Pressure injuries from lying in one position too long.
• A wound that reopens after surgery.
• Skin grafts.

Who Shouldn’t Use Vacuum-Assisted Closure?

Not everyone should use VAC. Doctors don’t recommend it if:

• You’re bleeding profusely.
• You have cancer.
• You have a lot of dead tissue around the wound. They may need to clear away the tissue with another method, such as debridement.
• Your wound contains exposed organs.

Possible Complications of Vacuum-Assisted Closure

Your doctor will look out for signs of complications from VAC, which may include:

• Excessive bleeding.
• Increased pain.
• Fever.
• An allergic reaction to the adhesive.

Taking Care of Your Wound with VAC

The VAC device stays on your wound 24/7, either in the hospital or at home. At home, a visiting nurse will need to change the dressing usually three times a week.

You may need VAC treatment for two to six weeks or longer. How long you need VAC treatments depends on the size and severity of your wound. You should follow your doctor’s instructions.

You may need to limit your activities while having VAC treatments. For instance, you may need to take sponge baths instead of showering.

If your doctor gives you pain medication or antibiotics, you should take them as directed.

You should call your doctor if:

• The wound starts bleeding.
• The bandage comes off.
• You have increased pain, swelling, or redness around the wound.
• The wound feels warmer than normal.
• Pus drains from the wound.
• You develop a fever.

Editor's Note: This article was originally published on August 10, 2022, and was last reviewed on October 4, 2022.