Amputation stump wounds (dehiscence, infection, necrosis) RSA: moderate 21 sources
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 27 sources
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 28 sources
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 59 sources
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 14 sources
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 22 sources
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 10 sources
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 25 sources
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 14 sources
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 20 sources
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 21 sources
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 6 sources
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 10 sources
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.
General reviews, mechanism, devices & guidelines 72 sources
Cross-cutting mechanism (the RSA Kairinos/Kahn perfusion series), device families, instillation technique, and economic and guidance documents that inform practice across indications.