Negative pressure wound therapy (NPWT) is a routine adjunct in plastic and reconstructive surgery, particularly as a temporising measure that stabilises complex wounds before coverage. The modern era of NPWT is traced to the 1990s development of vacuum-assisted closure (VAC). Foundational animal studies showed that controlled sub-atmospheric pressure could increase wound perfusion, accelerate granulation tissue formation, reduce bacterial counts in infected wounds, and improve random-pattern flap survival, providing a mechanistic basis for clinical adoption (1). Subsequent clinical experience reported favourable responses across a large, mixed cohort of acute, subacute and chronic wounds, with NPWT used until closure or until the wound was ready for grafting or flap rotation into a healthier, granulating bed. Thus, explicitly positioning NPWT as a step in a staged reconstructive pathway rather than an endpoint (2). In modern day practice, this ‘bridge’ concept supports serial debridement, controls exudate, reduces oedema, protects exposed tendon, bone or hardware, and promotes a uniform granulating surface that improves graft take and helps define the defect size for flap planning. It also enables time to optimise patient factors including nutrition, targeted anti-microbial treatment and anticoagulation management. Furthermore, it aids to coordinate theatre access and multidisciplinary care. While NPWT does not replace conventional options for wound coverage, its historical development in plastic surgery established a practical framework for temporisation and wound-bed preparation. 1.Morykwas MJ, Argenta LC, Shelton-Brown EI, McGuirt W. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg. 1997;38(6):553–562. doi:10.1097/00000637-199706000-00001. 2.Argenta LC, Morykwas MJ. Vacuum-assisted closure: a new method for wound control and treatment: clinical experience. Ann Plast Surg. 1997;38(6):563–576.