Negative pressure wound therapy (NPWT), negative pressure wound therapy with instillation and dwell (NPWT(i-d)) and Vacuum-assisted closure (VAC) devices have become a mainstay in post-surgical burn wound care leading to subsequent wound care coverage/closure. Deep second-, third- and fourth-degree burns require operative debridement of devitalized burn eschar, control and treatment of subsequent infectious complications, temporary wound coverage of the freshly debrided burn wound and subsequent open wound closure after the healthy development of appropriate granulation tissue. Over the last nearly 30 years NPWT/VAC and with the latest development of NPWT(i-d) have dramatically improved the efficiency to granulation and shortened the duration for burn wound closure. This has allowed for decreased cost of therapy, decreased number of operations and shortened hospital length of stay. These devices work by improving angiogenesis, removing inflammatory mediators as well as fluid removal to decrease tissue edema, contracting of the wound edges upon itself making the wound size smaller, improving prompt granulation tissue development all the while decreasing bioburden with the removal of microbes (bacterial and fungal organisms. NPWT(i-d), coupled with such cleansers as hypochlorous acid solutions, assists in the removal of biofilm and heavily contaminated microbial burn wounds colonized by difficult to eradicate bacteria such as Pseudomonas aeruginosa and fungal organisms. In addition, NPWT/VAC have facilitated the acceptance/take rates of both small and large split thickness skin grafts (STSG) and various flaps during the reconstruction phase of debrided burn wounds requiring wound closure. In this chapter the reader will be presented with the utilization of such NPWT/VAC/NPWT(i-d) devices used in the treatment and closure of debrided burn wounds.