§16§The role of Negative Pressure Wound Dressing in healing of diabetic foot ulcers has been proposed as a novel method of manipulating the chronic wound environment in a way that it reduces bacterial burden and chronic interstitial wound fluid, increases vascularity and cytokine expression and to an extent mechanically exploiting the viscoelasticity of periwound tissues. Additionally, the cyclical application of sub-atmospheric pressure alters the cytoskeleton of the cells in the wound bed, triggering a cascade of intra-cellular signals that increases the rate of cell division and subsequent formation of granulation tissue. A combination of these mechanisms makes the NPWD therapy a versatile tool in the armamentarium of wound healing. NPWD is generally well tolerated and, with few contraindications or complications, is fast becoming a mainstay of current wound care.
