Negative-pressure wound therapy (NPWT) has traditionally been used for the treatment of open wounds. In recent years, the indication for NPWT has been extended to include treatment of closed surgical incisions. Armstrong et al conducted a randomized controlled trial to determine whether NPWT delivered by the VAC system was clinically efficacious in treating amputation wounds of the diabetic foot to improve the proportion of wounds with complete closure. Treatment with NPWT resulted in a higher proportion of wounds that healed, faster healing rates, and fewer re-amputations than with standard treatment. No randomized controlled trials have been performed to assess NPWT and infection rates after major lower limb amputation.