Amputation stump wounds (dehiscence, infection, necrosis) RSA: moderate 48 sources
ICD-10 T87.5, T87.4, T87.6 · PMB via the underlying arterial/diabetic DTP (915E) · RSA endorsement WHASA 2021, Shweiki 2013
A dehisced, infected, or partially necrotic stump after major or minor lower-limb amputation — NPWT to salvage stump length and achieve closure without re-amputating to a higher level.
Closed-incision NPWT (ciNPT) prophylaxis over a high-risk incision RSA: strong 154 sources
ICD-10 I70.20, E11.5 · PMB via the underlying disease being operated on · RSA endorsement WHASA 2021 (strong), Andrews 2026
Prophylaxis over a primarily closed incision at high risk of dehiscence or surgical site infection — the vascular groin, the obese sternotomy, the re-do or contaminated-field closure.
Acute contaminated / dehisced surgical wound RSA: strong 147 sources
ICD-10 T81.4, T81.3 · PMB via the underlying condition / emergency framing · RSA endorsement WHASA 2021, Andrews 2026, Shweiki 2013
An acute, contaminated, or dehisced post-operative wound managed with NPWT for wound-bed preparation and closure — the general surgical case that surrounds the vascular ones.
Diabetic foot wounds (post-surgical and non-healing) RSA: strong 147 sources
ICD-10 E11.5, E10.5, E14.5, L97 · PMB 915E (diabetic PVD / gangrene); diabetes-with-complications pathway · RSA endorsement WHASA 2021 (first-line, ischaemia excluded) + WHASA 2015 diabetic-foot consensus, Ji 2021, Vig 2011; SVS/APMA/SVM 2016 (Grade 2B)
Post-surgical and non-healing diabetic foot wounds — one of the best-evidenced NPWT indications, once ischaemia is excluded.
Groin wound dehiscence / lymphorrhoea after femoral exposure or bypass RSA: strong 55 sources
ICD-10 T81.3, T81.4, I89.8 · PMB via the underlying arterial DTP (915E where gangrene/PVD coded) · RSA endorsement WHASA 2021, Pleger 2018 (RCT)
The commonest vascular-surgery NPWT scenario: a dehisced, infected, or leaking groin wound after femoral endarterectomy, bypass inflow, or arterial exposure. Two device modes apply — open-wound NPWT for an established defect and closed-incision ciNPT for prevention (see Closed-incision NPWT (ciNPT) prophylaxis over a high-risk incision).
Ischaemic / borderline-perfusion wounds — low-pressure NPWT (and when NOT to use it) Guarded 45 sources
ICD-10 I70.21, I73.9 · PMB 915E (via the underlying arterial disease) · RSA endorsement WHASA 2021 (with the red line), Kasai 2012
The indication that is also a contraindication if perfusion is not addressed. Handled candidly, it strengthens every other vascular NPWT letter because it shows the clinician knows the limit.
Necrotising soft-tissue infection / Fournier's gangrene RSA: moderate 26 sources
ICD-10 M72.66, N49.8, N76.8, A48.0 · PMB 349J / 277S (necrotising / anaerobic infection — life-threatening) · RSA endorsement WHASA 2021, Andrews 2026
Post-debridement management of necrotising fasciitis or Fournier's gangrene — NPWT/NPWTi-d as the wound-management adjunct after the life-saving surgery (radical debridement + antibiotics).
NPWT with instillation (NPWTi-d) — infected wounds needing cleansing RSA: moderate 62 sources
ICD-10 T81.4, M72.66 · PMB via the underlying infected condition · RSA endorsement WHASA 2021, Andrews 2026
A cross-cutting modality rather than a single anatomical indication: NPWT plus cyclic instillation and dwell for any wound that needs cleansing — infection, foreign material, heavy slough, or a bed needing extensive granulation.
Open abdomen / laparostomy and dehisced abdominal wound RSA: strong 45 sources
ICD-10 T81.3, K65.9 · PMB via the underlying abdominal emergency · RSA endorsement WHASA 2021 (strong), Andrews 2026
Temporary abdominal closure and management of the dehisced abdominal wall — relevant to the vascular service after ruptured aneurysm, mesenteric ischaemia, or abdominal compartment syndrome.
Post-operative and chronic wounds in peripheral arterial disease RSA: moderate 50 sources
ICD-10 I70.21, I70.20, L97 · PMB 915E (gangrene / severe atherosclerosis / diabetic PVD) · RSA endorsement WHASA 2021 (conditional on perfusion), Vikatmaa 2008
Post-operative or chronic lower-limb wounds in a patient with PAD — conditional on perfusion being addressed first. This is the indication that most needs the candid caveat.
Skin-graft bolster and wound-bed optimisation before grafting RSA: strong 72 sources
ICD-10 — · PMB via the underlying wound being grafted · RSA endorsement WHASA 2021, Evangelista 2013
Two uses: preparing a wound bed for grafting, and fixing a split-thickness skin graft as a bolster to improve take (over the awkward, mobile, or contoured recipient site).
Sternal wound / post-sternotomy mediastinitis RSA: strong 40 sources
ICD-10 T81.4, T81.3 · PMB via the cardiac-surgery emergency / underlying condition · RSA endorsement WHASA 2021 (method of choice), Grauhan 2013
Deep sternal wound infection / mediastinitis after cardiac surgery, and prophylaxis over the high-risk sternotomy closure. Included because the vascular/hyperbaric unit sees referred sternal wounds and because the evidence is strong.
Infected / exposed prosthetic vascular graft RSA: strong 30 sources
ICD-10 T82.7, I70.21, I73.9 · PMB 915E (via limb-/life-threatening framing + the underlying arterial DTP) · RSA endorsement WHASA 2021 (strong), EWMA 2017
The flagship vascular NPWT indication and the strongest funding case in this wiki: a limb- and life-threatening complication where NPWT can preserve the graft and avoid explantation.
These are browsing
categories, not clinical indications. Nothing filed here is a therapy a medical scheme would be
asked to fund in its own right.
Health technology assessment, coverage decisions and reimbursement criteria 31 sources
Candidate batches 10 and 11 both searched for this material and both reported it unreachable. NICE guidance is not indexed in PubMed; nothing from CADTH, HAS, MSAC, CONITEC or any Asian or African assessment body appeared as a primary publication. These documents had to be supplied rather than found, and none of the six carries a DOI or a PubMed identifier except Zens 2020.
Improvised and wall-suction NPWT 66 sources
NPWT delivered on a homemade or wall-suction circuit rather than a marketed device. Three randomised trials now compare the two head to head and find no difference over days on wound-bed surrogates; the circuit is far cheaper than a rented device and dearer than plain gauze, so the comparator decides the answer; none of the head-to-head trials reports healing, and all exclude the ischaemic limb. A browsing category, never the subject of a funding motivation.
NPWT safety, harms and adverse events 62 sources
Bleeding over vascular repairs and grafts, retained foam, device-related adverse events, and the harm figures that belong in a consent discussion. Collects what the wiki knows about how NPWT goes wrong.
Patient-reported outcomes and living with NPWT 20 sources
What patients report about pain, sleep, noise, odour, mobility, social limitation and device handling. Quantitative instrument data, qualitative interview work, and the information gap at discharge.
Venous leg ulcer 18 sources
NPWT in venous leg ulceration - as wound-bed preparation before grafting, as a graft bolster, and as an exudate-management strategy. Compression is the primary therapy throughout and is never displaced.
General reviews, mechanism, devices & guidelines 255 sources
Cross-cutting mechanism (the RSA Kairinos/Kahn perfusion series), device families, instillation technique, and economic and guidance documents that inform practice across indications.