Abstract
Negative pressure wound therapy (NPWT) is an established method for enhancing the healing of severe pressure injuries (PIs), but its high cost often limits access in low-resource settings. We present a case of a 16-year-old male with cervical spinal cord injury (SCI) who developed a Grade IV sacral pressure ulcer that was successfully treated using an improvised, cost-effective, in-house NPWT system. At first, daily cleaning and moist-to-wet saline gauze dressings, applied twice daily for one month, led to partial improvement. Given limited progress and restricted resources, a novel wound management approach using an in-house NPWT system was adopted. The wound demonstrated dramatic improvement in surface area, depth, and exudate clearance after four weeks, with a total material cost of ₹2,300 (USD $26) per session. This case demonstrates the feasibility, safety, and effectiveness of locally adapted NPWT and provides valuable insight for wound care in similar settings.