Knowledge and Self‐Reported Practice Gaps in Nurses' Application of Vacuum‐Assisted Wound Closure Therapy: A Multicenter Cross‐Sectional Study

AIM(S): To assess nurses' knowledge and self-reported practices regarding the clinical application of vacuum-assisted wound closure therapy and to examine the relationship between knowledge and self-reported practice. DESIGN: Multicountry descriptive-analytical cross-sectional survey. METHODS: A multicountry cross-sectional online survey was conducted among 1814 bedside nurses working in medical, surgical, intensive care, emergency, outpatient and operating-room settings in Palestine, Iraq, Saudi Arabia and Egypt. Participants completed a 37-item knowledge questionnaire and a 23-item self-reported practice checklist. Satisfactory classifications were defined at ≥ 75% (knowledge ≥ 28/37; self-reported practice ≥ 18/23). Descriptive statistics, Pearson correlation and hierarchical multiple linear regression were used. Workplace/country was modelled as a fixed categorical predictor; hospital-level clustering could not be modelled because hospital identifiers were unavailable. CONCLUSION: Substantial gaps in knowledge and self-reported guideline-based practice were identified among nurses using vacuum-assisted wound closure therapy, particularly in safety-related decision-making and the consistent completion of recommended care steps. These findings reflect self-reported behaviour and should not be interpreted as direct observations of clinical practice or patient outcomes. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Standardized guideline-driven education, competency assessment, and refresher training should be considered, with emphasis on indications and contraindications, precautions, device troubleshooting, monitoring and documentation. Future evaluations should verify practice using objective methods and assess patient-level outcomes before inferring effects on safety or wound healing. IMPACT: What problem did the study address? Variation and gaps in nurses' knowledge and self-reported guideline-based practice when using vacuum-assisted wound closure therapy; the study did not directly measure patient safety or healing outcomes. What were the main findings? No knowledge domain reached the study-specific 75% benchmark; 79.4% of nurses were classified below the practice benchmark, and knowledge was moderately correlated with self-reported practice (r = 0.512, p < 0.001). Higher knowledge and previous training were independently associated with higher self-reported practice scores, although large workplace effects require cautious contextual interpretation. Where and on whom will the research have an impact? The findings inform nurse educators, clinical leaders and wound care services in hospitals using vacuum-assisted wound closure therapy across the Middle East and North Africa clinical settings. REPORTING METHOD: This study followed the Enhancing Quality and Transparency of Health Research network guidance and used the Strengthening the Reporting of Observational Studies in Epidemiology checklist for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: Patients, service users, caregivers and members of the public were not involved in the design, conduct, analysis, interpretation, or manuscript preparation because the research focused on nurses' knowledge and self-reported clinical practices.