• Christian Willy, Hans-Ulrich Voelker, and Michael Engelhardt.
• Department of Surgery, Military Hospital Ulm, Ulm, Germany. PDDrmedChristianWilly@Bundeswehr.org.
• Eur J Trauma Emerg S. 2007 Feb 1;33(1):33-9.

IntroductionToday, vacuum therapy can be regarded as established in routine clinical use. Many hundreds of reports on the subject of vacuum therapy have appeared in medical literature. This review intends to give an overview of the peer-reviewed literature published to date and its quality considering criteria of evidence-based medicine (EbM).MethodsLiterature search (MEDLINE, EMBASE, Cochrane, extensive manual search); up to May 31, 2006; evidence level: Classification of the Oxford Centre for Evidence-based Medicine.ResultsFive hundred and fifty peer-reviewed citations were identified. Impressive jump in the annual publication rate is found from the year 2000 onwards; continuous broadening of the fields of indications; over 85% of all reports are case reports/series (only n = 27; EbM level < 4). To date, most of the publications are by authors from the United States, Germany, United Kingdom, Austria, the Netherlands, Switzerland, France, and Sweden. 7.5% of all peer-reviewed articles investigate scientific back grounds.DiscussionThe clinical significance of this therapy is underlined by an obviously continuously marked extension of the range of indications in all surgical fields, and even in extreme ages of the patients. There is a considerable deficit of basic pathophysiological research and well-designed studies. This "deficiency," however, when judged against the quality of the general medical literature, does not point to the poor efficacy or low benefit of vacuum therapy but should rather be seen as a symptom of the clinical practitioner's problems in dealing with modern aspects of the theoretical background of EbM.

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