The management of chronic, nonhealing wounds has been a challenge to medical professionals in all fields. There are more than 2.8 million patients with chronic wounds, with billions of dollars spent on treatment each year in the United States.1 A chronic wound can be defined as a break in the skin that never heals, recurs, or takes a prolonged time to heal. The most common chronic wounds include arterial and venous leg ulcers, pressure sores, and diabetic ulcers.2 Depending on the type and cause of the wound, management can involve various combinations of the following treatment options: multiple dressings changes per day, compression, topical antimicrobial agents, debridement, partial skin grafts, bioengineered skin products, and growth factors.3 The standard of care for chronic pressure wounds includes frequent debriding, off-loading, maintaining a moist environment, using normal saline for cleansing, controlling infection, and providing adequate nutritional support.4 Despite current treatments, many chronic wounds fail to heal or persist for months to years. The use of topical negative pressure devices (also described as topical negative pressure or vacuum-assisted closure [VAC]) has gained popularity in surgical and wound-healing fields. The devices also represent a possible new treatment option for clinicians. The goal of the present review was to evaluate the strength of the trials that have been performed to determine the effectiveness of topical negative pressure devices in healing chronic skin wounds.