Within the framework of the Three-Country Congress on VAC Treatment (Vacuum Assisted Closure Treatment) held on May 16/17 2003 in Salzburg, a Consensus Conference involving members of the Committees of the German and Austrian Societies for Wound Management was convened. In view of the divergence of opinion on the effectiveness of the treatment among the cost carriers, it appeared appropriate for the two Societies for Wound Healing in Germany and Austria to arrive at a consensus on the importance of and the indications for the management of wounds with the vacuum closure method. Since the first clinical applications in the nineteen-forties, both the indication spectrum and the number of applications have increased continually. In addition to diverse vacuum closure systems, there is patented computer-controlled system technology available that is established VAC treatment. Although this is a hospital-based system, it can also be used on an outpatient basis by appropriately trained physicians and nursing staff and in instructed patients. For some indications, vacuum closure and VAC management is considered the treatment of choice, since no equivalent alternative methods are available. A cost-benefit analysis shows that vacuum closure and VAC treatment is cost effective.