Hi,

In general, VAC promotes healing by evacuating unnecessary fluid which is accumulated inside the tissue and between the cells as well. On the other hand it sucks out possible bacteria, and modulate inflammatory reaction. Accordingly, you acquire better cell oxygenation, better communication between cells, less bacteria, faster vessels' I growth and granulation. It can also be used for skin grafts fixation. In summary less fluid inside, better cell communication, rapid healing.

There is more thorough approach:

http://www.sciencedirect.com/science/article/pii/S0011384014000847

Many thanks Marek. That link was very useful indeed. Mechanotransduction is a fascinating concept.

Thanks Klaus for your suggestion. Could you kindly elaborate on that please.

Please always remember that Topical Negative Pressure therapy, albeit very effective in achieving wound stimulation in stalled situations,  is absolutely contra-indicated in absent blood supply scenarios. So be sure that you know ABPI's, toe pressures and transcutaneous oxygen measurements  before you apply this modality. All the good it can do will be negated if your wound bed becomes ischaemic due to TNPT application on borderline bloodsupply. 

Thank you Hiske.

Would you mind elaborating please.

What about applying TNPT at a site adjacent (or proximal/distal) to an area of absent blood supply? Wouldn't TNPT in such a case be beneficial for the area of absent blood supply?