NEGATIVE PRESSURE WOUND THERAPY IN THE TREATMENT OF COMPLEX CUTANEOUS WOUNDS: IMPACT ON HEALING, INFECTION CONTROL, AND THE NEED FOR SURGICAL RECONSTRUCTION

Abstract

Complex cutaneous wounds represent a major clinical challenge because of extensive tissue loss, exposure of deep structures, contamination, infection, vascular impairment, and difficulty achieving adequate closure. In this context, negative pressure wound therapy (NPWT) has become a widely used adjunctive strategy for wound preparation and management, particularly by facilitating exudate removal, edema reduction, wound-edge approximation, granulation tissue formation, and optimization of the local wound environment. This study aimed to analyze the impact of negative pressure wound therapy on healing of complex cutaneous wounds, infection control, and the need for reconstructive procedures. An integrative literature review was conducted, prioritizing studies published between 2020 and 2026, using scientific databases and selecting studies addressing NPWT in traumatic, surgical, infected, diabetic, burn wounds and situations requiring reconstruction. Thirty-two studies were selected for qualitative synthesis. Current evidence demonstrates benefits of NPWT in reducing wound area, promoting granulation tissue formation, and controlling exudate, while recent meta-analyses indicate reduced surgical site infection rates in several clinical settings. NPWT may also serve as a bridge to definitive reconstruction, allowing stabilization of the wound bed and, in selected cases, the use of less complex reconstructive procedures. However, outcomes vary according to wound etiology, depth, perfusion, infection, and quality of debridement. It is concluded that NPWT represents an important component of multimodal complex wound management, but it does not replace adequate debridement, infection control, vascular assessment, or definitive reconstruction when indicated.