Negative pressure wound therapy (NPWT) is an established intervention used across a range of clinical settings, from hospital-based acute and surgical care to community and home environments. By applying controlled negative pressure to the wound bed, NPWT can encourage healing through several mechanisms such as drawing wound edges together, stimulating granulation tissue formation, removing debris, reducing oedema and managing exudate (Apelqvist et al, 2017).
Despite its recognised clinical benefits, patient safety concerns reported through NHS England’s Learning from Patient Safety Events (LFPSE) service have identified episodes of significant and, in some instances, life-threatening bleeding associated with the use of NPWT across the UK.
Analysis indicates that the NPWT device itself is not the primary cause of harm. Instead, contributory factors include gaps in clinical decision-making, inadequate risk assessment, delayed escalation, insufficient staff training, communication failures, particularly during transitions of care and inconsistent adherence to device and canister observation schedules following surgical debridement (Chetter et al, 2020).
These findings highlight the need for structured guidance to support clinical decision-making when initiating and managing patients receiving NPWT. This includes appropriate patient selection, holistic assessment, ongoing monitoring and clear safety-netting arrangements (providing patients and carers with clear guidance on warning signs and when to seek further help) to ensure patients and carers can access timely clinical support and escalate concerns when required, and accurate, transparent documentation.
This Consensus Document was developed following a multidisciplinary consensus meeting held in London in March 2026.
The purpose of this Consensus Document is to provide clinicians with practical, evidence-informed guidance on how to initiate treatment safely, and manage at-risk patients receiving NPWT, focussing particularly on the recognition and management of bleeding complications, safe initiation, transfer or discharge practices and clear escalation pathways. Practical tips are included throughout to support clinical decision-making and prioritise patient safety.
Jacqui Fletcher (Chair)
Download the PDF below to access the full consensus document.
