The authors suggested that split-thickness skin grafts might provide the ideal indication for the adoption of gauze-based NPWT. According to the author’s experiences, the gauze-based system seems to be more useful and feasible for group B or grade 1 and 2 wounds. The gauze medium may require using more material to fill in a large and deep wound compared to foam. This can raise cost of treatment. However, recent reports indicated that the type of interface material does not affect the pressure transduction to the wound.18,19 Comparative and prospective studies are needed to assess the efficacy of a gauze-based system on large and deep wounds. The aim of NPWT is to prepare the wounds for surgery. The excessive use of this method can lead to extended duration of hospitalization and increased cost of treatment. NPWT should be considered a temporary or bridge technique for management of wounds, meaning it is used to promote wound healing before closure, either by secondary intention or by grafting or flap placement.7 In the postoperative period, sufficient and proper wound care, as well as passive and active exercises, are essential for providing long-lasting positive results and reducing recurrence rate. The patients should not lie down or sit down on their flaps for 3 weeks. At the end of the 3-week period, patients can sit down on the flap for only 15 minutes a day. In the authors’ study, 3 patients required secondary surgery in postoperative 6 months. These patients had SPS (1 case) and IPS (2 cases) pressure ulcers. The gauze-based NPWT was reused in only 1 patient with an IPS because of total dehiscense. IPSs have a high incidence of recurrence despite successful reconstructive treatments. In the literature, it is reported that the reoccurrence rate ranges from 27.8% to 63%. In IPSs, myocutaneous flaps can be used to reduce recurrence rate and the wounds should be protected from long-lasting pressure and shearing forces as an important factor in decubitis ulcers, especially in paraplegics.