Prospective RCT enrolling 88 high-energy trauma patients across two parallel arms: draining postoperative hematomas and surgical incisions after calcaneus, pilon, or Schatzker IV–VI tibial plateau fractures. Patients were randomized to standard pressure dressings versus VAC-based NPWT to determine whether NPWT accelerates wound closure in these two distinct scenarios.
When closing high-risk lower extremity fracture incisions (calcaneus, pilon, Schatzker IV–VI tibial plateau) or managing a persistently draining postoperative hematoma, NPWT over an intact sutured wound cuts drainage time roughly in half compared with standard dressings — but this early RCT was underpowered to confirm a reduction in infection or dehiscence, so NPWT should be viewed as an adjunct to meticulous soft-tissue management, not a substitute for it.
Prospective RCT enrolling 88 high-energy trauma patients across two parallel arms: draining postoperative hematomas and surgical incisions after calcaneus, pilon, or Schatzker IV–VI tibial plateau fractures. Patients were randomized to standard pressure dressings versus VAC-based NPWT to determine whether NPWT accelerates wound closure in these two distinct scenarios.
When closing high-risk lower extremity fracture incisions (calcaneus, pilon, Schatzker IV–VI tibial plateau) or managing a persistently draining postoperative hematoma, NPWT over an intact sutured wound cuts drainage time roughly in half compared with standard dressings — but this early RCT was underpowered to confirm a reduction in infection or dehiscence, so NPWT should be viewed as an adjunct to meticulous soft-tissue management, not a substitute for it.