Clinical evidences, personal experiences, recent applications

Management of difficult wounds can be a complex, challenging expensive task, especially for wounds showing slow healing process. Topical negative pressure(TNP) therapy has greatly improved difficult wounds. It allows to treat patient on an outpatient, to reduce the complication rate with hospital stay, to avoid frequent dressings with advanced materials and allow a lower commitment health professionals. Vacuum Assisted Closure®(VAC®) system is a therapeutic device based on the administration a controlled TNP introduced by Morykwas Argenta in 1997. It is indicated in different kinds of, but clinical evidences are present only for few of. In this work we summarize indications and recommendations VAC® therapy and we analyze the actual choice of treatment based on evidences and personal in order to stimulate further studies. we introduce recent applications of VAC® system as Prevena®, VAC Instill® and VAC Via®. Prevena® is system based on TNP indicated in the management of wounds that present risk factors for dehiscence. Instill® is a system that allows to associate TNP and administration of solutions, such as antibiotics or, to treat specific type of wounds. VAC Via® a device based on TNP, characterized by little dimension a preset system that allow the treatment of wounds for 7 d, with no impairment for the patient. aim of our paper is to describe a report of VAC® use in order to stimulate further studies and to the level of evidence of VAC® therapy.