The study aims to assess the significance of negative pressure therapy in the treatment of 1 January 2014 - 31 June 2017. The objectives intend to evaluate the healing time required after applying the method and the functional consequences for the patient. A prospective study was conducted on a sample of 31 patients with various tipe of wounds which were monitored their clinical course between September 2014 - February 2017, following negative pressure therapy. There were used vacuum assisted closure devices (VAC � -Hartman) in order to apply negative pressure to the wound, while complying with specified settings in accordance with patients� outcome. Healing was obtained in all cases, to an average hospital stay of 30 days and 12 days of therapy application.The negative result of microbial cultures was obtained after an average of 7.55 days by simultaneous application of negative pressure and antibiotic treatment according to the antibiogram. After basic treatment of the wound, auxiliary methods such as negative pressure contribute to the healing. Evolution was favorable with wound granulation in 95% cases, which allowed surgery under local anesthesia, and defect was covered with skin graft. VAC therapy falls into the last group of treatments by eliminating healing inhibitors. This regenerates the wound in a damp environment and essentially turns an open wound into a closed system.

We present the case of a 52-year-old male with severe hemophilia A with inhibitors, who was diagnosticated with acute lithiasic cholecystitis that required surgical intervention due to lack of favorable response to conservatory treatment. During surgery, hemostatic support was performed with activated recombinant factor VII (rFVIIa, NovoSeven®). The surgery was performed first laparoscopically with adhesiolysis, followed by subcostal laparotomy and cholecystectomy because of the findings of a pericholecystic plastron with abscess and massive inflammatory anatomical modifications. The patient presented postoperative complications, requiring a second surgical intervention, due to the installation of a hemoperitoneum. Hemostatic treatment with rFVIIa was given for a further 3 weeks postoperatively, and the patient was discharged in safe condition. A surgical intervention increases the risk of bleeding in hemophilic patients, which may have vital complications in the absence of adequate hemostatic support and the support of a multidisciplinary team with experience in hemophilic surgery.