Appropriate timing and dosing of antibiotics, type of skin preparation, temperature of the patient in the operating room, blood oxygen level of the patient during surgery, and management of blood glucose levels all have been standardized in an attempt to decrease wound infection rates . In addition, debridement of all tissue that may contribute to wound infection, particularly ischemic skin and subcutaneous tissue, is standard surgical procedure. Standardization has led to a small decrease in incidence but has not led to a significant reduction in the overall rate. One reason for this is the multifactorial nature of SSI development. Factors regarding patients and pre-operative status, operative procedures and intra-operative events, as well as postoperative course, all need to be addressed, and there is not a complete understanding of their range and impact. What is known is that at the time of wound closure, one needs a minimal number of bacteria in the wound, and the wound itself must be reasonably well perfused and oxygenated. After surgery, wound perfusion and oxygenation are evaluated by clinical appearance. If the wound does not appear ischemic, it is assumed that perfusion and oxygenation are adequate. Unfortunately, this has never been quantified. Negative-pressure wound therapy (NPWT) has been used to speed the healing of open wounds.