| Summary: | 1. The scientific documentation on vacuum assisted closure therapy offers some evidence that the method: 1.1. yields faster healing and a higher percentage of healed wounds in patients with split-thickness skin grafts for wounds that are not "surgically clean", in patients with inflammation in the thoracic cavity (mediastinitis) following surgery where the sternum is divided (sternotomy), and in patients with diabetes where gangrene necessitates forefoot amputation. 1.2. leads to fewer infections and fewer wound complications in patients with orthopaedic trauma and open fractures. 1.3. leads to a shorter length of hospital stay for patients with split-thickness skin grafts for wounds that are not "surgically clean". 1.4. reduces mortality in post-sternotomy patients with mediastinitis. 2. The utility of the method is uncertain in many clinical situations. The review of the scientific documentation reveals a lack of well-executed studies involving patients with split-thickness skin grafts in otherwise "healthy" wounds, with open abdominal wounds, with a necrotising fasciitis, with severe deep infection in the tissues between the urethra and the rectum (Fournier gangrene), with an open wound after fasciotomy, or with a tissue defect following musculoskeletal tumour surgery. 3. Randomised, controlled trials of different well-defined wound types are urgently needed. There continues to be a lack of good-quality health economic assessments
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