iabetic foot disease is a major global burden. Foot ulcers frequently develop complications and become chronic, representing a considerable challenge as these are typically very difficult to treat. New therapies are needed to address these wounds and there is an increasing focus on negative pressure wound therapy (NPWT). This technique has been shown to accelerate wound healing and although its costs are significant, there is also evidence to show that it compares favourably with more conventional alternatives. However, most studies to date have been small, and larger trials are needed before NPWT becomes more routine. In the meantime, the procedure may be most suitable for large, chronic, heavily exuding wounds that do not respond to established therapies.